Juvenile onset spondyloarthritis

Juvenile spondyloarthritis, also called juvenile onset spondyloarthritis (JSpA) and juvenile idiopathic arthritis – enthesitis related arthritis (JIA-ERA)

Juvenile spondyloarthritis describes a group of arthritic diseases that start before the 16th birthday.

The term juvenile idiopathic arthritis (JIA) was introduced to standardize and classify the different arthritic conditions seen in children.

Juvenile spondyloarthritis is now classified as enthesitis related arthritis (ERA) in this new system. Enthesitis is inflammation where tendons or ligaments attach to the bone.

Enthesitis is a major manifestation of SpA especially in children. In fact unlike adult onset SpA, JSpA/ERA may start as peripheral arthritis or enthesitis in the majority with axial manifestations appearing only later on.

JSpA includes all the spondyloarthritis diseases of ankylosing spondylitis, psoriatic arthritis, reactive arthritis, enteropathic arthritis (arthritis associated with inflammatory bowel disease) and undifferentiated spondyloarthritis.

Symptoms juvenile onset spondyloarthritis

  • Enthesitis in the lower body
  • Pain in the pelvis, hips, knees and ankles
  • Swollen knees and ankles
  • Pain and inflammation in the spine
  • Psoriasis and other skin rashes
  • Uveitis or iritis
  • Crohn’s disease or colitis (inflammation of the intestines)
  • Tiredness and fatigue

Diagnosis of juvenile onset spondyloarthritis

A pediatric rheumatologist is best placed to provide a diagnosis because JSpA symptoms can come and go. A thorough physical exam looking for enthesitis and a complete health history recording symptoms and a family history will help with the diagnosis. Although the presence of HLA-B27 may be useful in helping with the diagnosis, it does not provide a definitive diagnosis.


Learn about the management of juvenile onset spondyloarthritis.