Paediatrics Publications

Title

Atypical monoarthritis presentation in children with oligoarticular juvenile idiopathic arthritis: A case series

Document Type

Article

Publication Date

1-13-2017

Journal

Pediatric Rheumatology

Volume

15

Issue

1

URL with Digital Object Identifier

10.1186/s12969-016-0129-x

Abstract

Background: Oligoarticular juvenile idiopathic arthritis (oligoJIA), the most common chronic inflammatory arthritis of childhood, usually involves the knees and ankles. Severe oligoJIA monoarthritis presenting in a joint other than knees and ankles, is rare. Findings: We report four children who presented with severe isolated arthritis of the hip, wrist or elbow and were diagnosed with oligoJIA. All four were girls with a median age of 11.5 years. Those with hip arthritis also met the classification criteria for juvenile-onset spondylarthopathy. Median duration of symptoms prior to diagnosis was 9.5 months. Three children had already cartilage loss or erosive disease at diagnosis. Conclusions: Children diagnosed with oligoJIA that present with monoarthritis of the hip, wrist and elbow can have aggressive disease. Girls with positive HLA-B27 presenting with isolated hip arthritis could meet the classification criteria for both oligoJIA and juvenile-onset SpA. Early referral to specialized care may improve their diagnosis, treatment and outcome.

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