What is Juvenile Ankylosing Spondylitis?
Juvenile ankylosing spondylitis is an inflammatory condition affecting children and young adults. It is seen mostly affecting the spine but can also affect the area where the tendons and ligaments meet the bone. It can also affect other areas and organs of the body.
- Juvenile onset
- Adult onset
How Does Juvenile Ankylosing Spondylitis Affect the Body?
Juvenile ankylosing spondylitis causes inflammation in the bones of the hip, knees, back, and buttocks. As the condition progresses the bones in the spine fuse leading to stiffness. If the bones in the rib cage fuse, it can lead to difficulty in breathing.
If it affects the eyes, it leads to chronic eye inflammation or uveitis. This leads to pain, redness, dryness, difficulty seeing, and light sensitivity.
In case of pinching of the nerve of the back, there is weakness or numbness of the legs and pain in the thighs and buttocks.
Causes and Risk Factors of Ankylosing Spondylitis
What exactly causes Juvenile ankylosing spondylitis is not known but is believed to be linked with the genetic marker the HLA-B27.(2) Approximately 80-90% of children and young people with juvenile ankylosing spondylitis have the HLA-B27 gene.(3)
It is believed that children with this gene when exposed to viruses, bacteria, or other environmental conditions develop juvenile ankylosing spondylitis.
Males are more at risk of developing this condition. Also, if a family member has this condition the risk of developing it increases.(4)
Symptoms of Juvenile Ankylosing Spondylitis
The symptoms of juvenile ankylosing spondylitis develop when a person reaches his 20s. In 18% of people, it may be found to develop earlier and is referred to as juvenile-onset.(4)
The symptoms start with pain in the hip, knees, or heels. Next develops pain in the lower back and buttocks.
The common symptoms of juvenile ankylosing spondylitis include:
- Inactivity or stiffness on waking
- Pain in the buttocks, knees, heels and bottom of the feet
- Abdominal symptoms
- Pain in the eyes, redness, and light sensitivity
- Swelling and warmth in the joints
- Difficulty in standing, sitting, or bending to touch the knees
Other symptoms include:
- Shortness of breath
- Loss of appetite
- Mild fever
- Back pain during morning and night
- Pain, swelling, and warmth in the toes, ankle, heels, rib cage, shoulders, and upper spine
The symptoms of juvenile ankylosing spondylitis are similar to other conditions. It is therefore important to consult a pediatrician for proper diagnosis.
Diagnosis of Ankylosing Spondylosis
A detailed medical history of the family is taken, to check whether or not ankylosing spondylosis is in the family history.
Blood tests are performed to look for antigens that indicate the presence of the HLA-B27 gene marker, which is linked to an increased risk of juvenile ankylosing spondylitis.
Treatment of Ankylosing Spondylosis
The treatment may include medication, physical therapy, exercise, and surgery.
Medications including non-steroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, biologics, and corticosteroids are prescribed.
Physical therapy helps in strengthening the body and preserving and improving flexibility. An occupational therapist may provide assistive devices and skill training to make it easy to carry out everyday functions.
Surgery is advised in very rare cases of juvenile ankylosing spondylitis. Joint replacement and spinal surgery are seen to be helpful in alleviating pain.
Other Treatment Options Include:
Acupuncture is a traditional therapy that focuses on placing fine needles at the points on the skin that may help in relieving the natural pain-relieving hormones.
Alexander’s technique teaches the person how to improve posture and increase functionality. It makes the person more aware of the body.
Massage therapy also helps but should be given gently as it can cause a flare-up.
A TENS unit is a control unit that is attached to the skin using wires and electrodes. It delivers short pulses of electrical impulses of varying strength, frequency, and duration into the body.
Diet and posture can be helpful in managing the symptoms of chronic conditions.
A diet rich in anti-inflammatory foods such as whole grains, fatty fish, and other elements of the Mediterranean diet is a good choice for juvenile ankylosing spondylitis.
Maintaining a good posture can be helpful in alleviating pain and lessening stiffness.
Complication of Juvenile Ankylosing Spondylitis
Juvenile ankylosing spondylitis may complicate and lead to:
- Joint damage
- Fusion of spine or rib cage
- Heart, eye, and kidney problems
- Trouble breathing
Early diagnosis and medical care can be helpful in addressing complications as they arise.
Also, if a child develops eye symptoms, trouble breathing, and new or worsening symptoms a doctor should be consulted.
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