TY - JOUR T1 - Spondyloarthritis in a Pediatric Population: Risk Factors for Sacroiliitis JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.100014 SP - jrheum.100014 AU - Matthew L. Stoll AU - Rafia Bhore AU - Molly Dempsey-Robertson AU - Marilynn Punaro Y1 - 2010/08/03 UR - http://www.jrheum.org/content/early/2010/07/29/jrheum.100014.abstract N2 - Objective Pediatric rheumatologists may have an opportunity to diagnose sacroiliitis in its early stages, prior to the development of irreversible radiographic changes. Early diagnosis frequently requires magnetic resonance imaging (MRI), the use of which is limited by expense and requirement for sedation. We set out to identify features of juvenile spondyloarthritis (SpA) associated with the highest risk of sacroiliitis, to identify patients who may be candidates for routine MRI-based screening. Methods We reviewed the charts of 143 children seen at Texas Scottish Rite Hospital for Children diagnosed with SpAbased on the International League ofAssociations for Rheumatology criteria for enthesitis-related arthritis or the Amor criteria for SpA.We performed logistic regression analysis to identify risk factors for sacroiliitis. Results A group of 143 children were diagnosed with SpA. Consistent with the diagnosis of SpA, 16% had psoriasis, 43% had enthesitis, 9.8% had acute anterior uveitis, and 70% were HLA-B27+. Fifty-three children had sacroiliitis, of which 11 cases were identified by imaging studies in the absence of suggestive symptoms or physical examination findings. Logistic regression analysis revealed that hip arthritis was a positive predictor of sacroiliitis, while dactylitis was a negative predictor. Conclusion Children with SpA are at risk for sacroiliitis, which may be present in the absence of suggestive symptoms or physical examination findings. The major risk factor for sacroiliitis is hip arthritis, while dactylitis may be protective. Routine screening by MRI should be considered in patients at high risk of developing sacroiliitis. ER -