Skip to main content

Enthesitis-Related Arthritis

 Enthesitis-Related Arthritis



Enthesitis-related arthritis (ERA) is one of several types of juvenile idiopathic arthritis (JIA). These childhood autoimmune conditions begin before the child’s 16th birthday and can evolve, flare, or improve over time.

Enthesitis is the painful inflammation of the entheses, the fibrous connective tissue that attaches your tendons and ligaments to your bones. There are over 100 entheses in your body.

In ERA, your immune system mistakenly attacks both joints and entheses, leading to inflammation. Children with ERA may have swelling, pain, and stiffness of multiple joints and entheses, along with other symptoms.

Although ERA is a chronic disease, treatment can manage symptoms and even cause them to go into remission.

What are the symptoms of enthesitis-related arthritis?

Common symptoms include:

enthesitis (pain where tendons or ligaments join bones), most often at the lower part of the kneecap and the heel

arthritis (pain, swelling, and stiffness) of any joint, most often the hip, knee, ankle, shoulder, and sacroiliac joint

fever

uveitis (painful red eye, vision changes)

gut inflammation ranging from mild, nonspecific symptoms to inflammatory bowel disease

What causes enthesitis-related arthritis?

ERA and other forms of JIA are inflammatory autoimmune disorders. In these conditions, your immune system mistakenly begins attacking your own body.

In ERA, your immune system attacks your joints and entheses, causing inflammation, pain, and swelling at affected sites.

Doctors aren’t yet sure what causes the immune system to misfire. They suspect a combination of:

genetic risk factors

infections

microtrauma to the entheses

other environmental triggers

How do doctors diagnose enthesitis-related arthritis?

Your doctor will discuss your child’s symptoms and family medical history, perform a physical exam, and order blood tests. Imaging tests like X-rays, ultrasounds, or MRIs may also help.

Your child may also need to see other specialists to help diagnose and treat ERA, such as:

rheumatologist

ophthalmologist

physical therapist

What is the treatment for enthesitis-related arthritis?

If your child receives a diagnosis of ERA, you’ll see both a primary care pediatrician and a rheumatologist who specializes in immune-mediated conditions. Depending on symptoms, your child might also see an ophthalmologist, gastroenterologist, or physical or occupational therapist.

Medications help treat ERA symptoms and prevent damage to your joints. Your doctor might suggest anti-inflammatory therapies like:

nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or diclofenac

sulfasalazine

methotrexate

biologics, such as anti-TNF-alpha agents

In certain circumstances, a doctor might consider steroid injections into the joint or enthesis.

Exercise regimens encouraging stretching and flexibility, supportive shoe inserts, and ice application can also help you manage symptoms and stay active.

What is the outlook for people with enthesitis-related arthritis?

ERA is a chronic autoinflammatory disease requiring long-term monitoring and treatment. Research Trusted Source suggests that children with ERA experience more persistent problems with pain and function than those with other forms of JIA.

Children with ERA often experience evolving symptoms into adulthood. But symptom management and even complete remission are possible.

Only a few studies have explored long-term outcomes in children with ERA. One older study found that approximately 15 years after diagnosis, 44%Trusted Source of ERA patients were in remission, though long-term complications such as reduced spinal flexion were common.

Type of Doctor Department :  A rheumatologist

Comments

Post a Comment

Popular posts from this blog

Charge Syndrome

Overview CHARGE syndrome is a recognizable genetic syndrome with known pattern of features. It is an extremely complex syndrome, involving extensive medical and physical difficulties that differ from child to child. CHARGE syndrome is correlated with genetic mutation to CHD7 and the prevalence of CHARGE syndrome is 1:10,000-1:15,000 live births. Babies with CHARGE syndrome are often born with life-threatening birth defects. They spend many months in the hospital and undergo many surgeries and other treatments. Swallowing and breathing problems make life difficult even when they come home. Most have hearing two little girls sitting on a carpet, one girl has a trach and is biting her finger.loss, vision loss, and balance problems that delay their development and communication. Despite these seemingly insurmountable obstacles, children with CHARGE syndrome often far surpass their medical, physical, educational, and social expectations. One of the hidden features of CHARGE syndrome is the ...
7 comments
Read more

Dehydration Due to Diarrheal Diseases

Overview Dehydration occurs when you use or lose more fluid than you take in, and your body doesn't have enough water and other fluids to carry out its normal functions. If you don't replace lost fluids, you will get dehydrated. Anyone may become dehydrated, but the condition is especially dangerous for young children and older adults. The most common cause of dehydration in young children is severe diarrhea and vomiting. Older adults naturally have a lower volume of water in their bodies, and may have conditions or take medications that increase the risk of dehydration. This means that even minor illnesses, such as infections affecting the lungs or bladder, can result in dehydration in older adults. Dehydration also can occur in any age group if you don't drink enough water during hot weather — especially if you are exercising vigorously. You can usually reverse mild to moderate dehydration by drinking more fluids, but severe dehydration needs immediate medical treatment. ...
Post a Comment
Read more

Ataxia with Vitamin E Deficiency

Synonyms of Ataxia with Vitamin E Deficiency AVED Familial Isolated Vitamin E Deficiency Isolated Vitamin E Deficiency General Discussion Ataxia with vitamin E deficiency (AVED) is a rare inherited neurodegenerative disorder characterized by impaired ability to coordinate voluntary movements (ataxia) and disease of the peripheral nervous system (peripheral neuropathy). AVED is a progressive disorder that can affect many different systems of the body (multisystem disorder). Specific symptoms vary from case to case. In addition to neurological symptoms, affected individuals may experience eye abnormalities, disorders affecting the heart muscles (cardiomyopathy), and abnormal curvature of the spine (scoliosis). AVED is extremely similar to a more common disorder known as Friedreich’s ataxia. AVED is inherited as an autosomal recessive trait. Vitamin E deficiency often occurs secondary to disorders that impair the absorption of vitamin E from fat including liver disorders, disorders of fat...
Post a Comment
Read more