1/3. HLA-B27 positive juvenile arthritis with cardiac involvement preceding sacroiliac joint changes.While cardiovascular disease develops in up to 50% of adult patients with ankylosing spondylitis, it is very uncommon in its juvenile counterpart. Regarding the early stage of the disease, before onset of sacroiliac joint changes, only two cases with aortic incompetence have been published while reports of mitral valve involvement are not available. A 13 year old boy is described with an HLA-B27 positive asymmetric oligoarthritis and enthesitis, without back pain or radiographic evidence of sacroiliitis. echocardiography showed an echogenic structure measuring 8 x 11 x 20 mm at the fibrous continuity between the aortic and mitral valves extending through a false tendon into an echogenic thickened posterior papillary muscle, causing a grade II aortic and grade I/II mitral regurgitation. Short term corticosteroid and long term non-steroidal anti-inflammatory drug and disease modifying antirheumatic drug treatments efficiently controlled the symptoms. The cardiac findings remained unchanged during a follow up of 20 months. Careful cardiac evaluation appears to be mandatory even in these young patients.- - - - - - - - - - ranking = 1keywords = spondylitis (Clic here for more details about this article) |
2/3. Post-traumatic knee pain leading to the diagnosis of spondyloarthropathy.The authors report a patient with persistent left knee pain after traumatic injury. The initial bone scan seemed to confirm a valgus stress knee injury. The final diagnosis, however, was focal inflammation of the knee ligaments (enthesopathy) related to ankylosing spondylitis. The diagnostic procedure and the results of other imaging modalities are presented. The bone scan findings are discussed.- - - - - - - - - - ranking = 1keywords = spondylitis (Clic here for more details about this article) |
3/3. shoulder, knee, and hip pain as initial symptoms of juvenile ankylosing spondylitis: a case report.Ankylosing spondylitis is a systemic disease typically manifested by persistent back pain or stiffness unrelieved by rest. Although not often recognized, ankylosing spondylitis can also cause peripheral joint pain, particularly in the hips, knees, ankles, and shoulders. In the pediatric form of the disease, juvenile ankylosing spondylitis, peripheral joint involvement is more frequent and can precede, by many years, the onset of back symptomatology. The following case is an example of a teenager who presented to physical therapy with a variety of common peripheral joint complaints over a 3-year period. Eventually, he was diagnosed with juvenile ankylosing spondylitis. Lack of awareness of the manifestations of ankylosing spondylitis and juvenile ankylosing spondylitis may lead to significant delay in diagnosis and initiation of appropriate therapy. A physical therapist may be the first health professional to assess a patient's lack of response to treatment for a seemingly typical diagnosis and should be aware of potential alternate diagnoses.- - - - - - - - - - ranking = 10keywords = spondylitis (Clic here for more details about this article) |