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Atypical spondyloarthritis in children: proposed diagnostic criteria

  • Immunology/Allergology
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Abstract

Clinical and laboratory findings in 26 children with atypical spondyloarthritis were compared with those of 76 children with juvenile rheumatoid arthritis. The sensitivity, specificity, predictive value, and efficiency for diagnosis were calculated. The following findings (major criteria) were much more common in atypical spondyloarthritis than in juvenile rheumatoid arthritis: (1) spondyloarthritis within the family; (2) enthesopathy; (3) arthritis of digital joints; (4) sacro-iliitis; (5) presence of HLA-B27; (6) frequent recurrence of arthritis and arthalgia. Six additional findings (minor criteria) were significantly more common in atypical spondyloarthritis (SA): (1) disease onset after the age of 10 years; (2) male sex; (3) involvement of the lower extremities; (4) acute iridocyclitis or conjunctivitis; (5) arthritis of the hip joints; (6) manifestation following a history of enteritis. In the presence of 4 major criteria or 3 major and 3 minor criteria, the diagnosis of an atypical SA was established with a sensitivity of 84.6%, a specificity of 100%, and an efficiency of 96.1%.

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Abbreviations

AS:

ankylosing spondylitis

JRA:

juvenile rheumatoid arthritis

RA:

rheumatoid arthritis

RF:

IgM-rheumatoid factor

RS:

Reiter syndrome

SA:

spondyloarthritis

SEA-Syndrome:

syndrome of seronegative enthesopathy and arthropathy

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Authors and Affiliations

  1. Zentrum Kinderheilkunde und Humangenetik, Medizinische Hochschule, Postfach 610180, D-3000, Hannover 61, Germany

    A. Hussein, H. Abdul-Khaliq & H. von der Hardt

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  1. A. Hussein
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  2. H. Abdul-Khaliq
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  3. H. von der Hardt
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Hussein, A., Abdul-Khaliq, H. & von der Hardt, H. Atypical spondyloarthritis in children: proposed diagnostic criteria. Eur J Pediatr 148, 513–517 (1989). https://doi.org/10.1007/BF00441545

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  • DOI: https://doi.org/10.1007/BF00441545

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