Juvenile onset AS (JAS) and Psoriatic (JPA)

Question 1

JAS age?

Answer 1

• Typically see onset at 3 to 15 years of age.

Question 2

JAS joint pattern?

Answer 2

• An asymmetric arthritis generally is observed, and the articulations of the lower limbs are affected, particularly the ankle, the knee, and the intertarsal joints.
• The joints of the upper extremity are relatively spared.
• Spinal and SI findings difficult to interpret on x-ray until 2nd decade.

Question 3

JAS eye findings?

Answer 3

• Acute iridocyclitis is not a common presenting feature of the disease but subsequently is apparent in as many as 25 per cent of patients.

Question 4

JAS family Hx?

Answer 4

o HLA-B27 may be detected in approximately 90 per cent of affected children

Question 5

JPA presentation?

Answer 5

• In a small subgroup of children with juvenile chronic arthritis, articular involvement may antedate psoriatic skin disease and can be characterized by severe and progressive joint destruction.
• Asymmetric articular involvement with periods of remission and exacerbation is most characteristic.
• Radiographic abnormalities can simulate those in adults with psoriatic arthritis, including distal interphalangeal joint destruction, phalangeal tuftal resorption, and sacroiliitis.