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Juvenile enthesitis-related arthritis (ERA)JJuvenile enthesitis-related arthritis (ERA)Juvenile enthesitis-related arthritis (ERA)EnglishRheumatologyChild (0-12 years);Teen (13-18 years)Back;Knee;Ankle;Foot;HipImmune system;Ligaments;TendonsConditions and diseasesCaregivers Adult (19+)NA2016-08-12T04:00:00Z8.5000000000000056.80000000000001133.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Juvenile enthesitis-related arthritis includes swelling and pain where tendons and ligaments attach to bone. It affects more boys than girls.<br></p><h2>What is juvenile idiopathic arthritis (JIA)?</h2> <p>Juvenile idiopathic arthritis (JIA) is arthritis that affects children who are less than 16 years old. It is also called childhood arthritis.</p> <p>Arthritis means "joint swelling" or "joint inflammation." Arthritis leads to pain, swelling, stiffness and loss of motion in the joints. "Idiopathic" means that we do not know the cause.</p> <h2>What is enthesitis-related arthritis (ERA)?</h2> <p>There are many different types of arthritis. Enthesitis-related arthritis (ERA) is one type. Patients with ERA not only have joint swelling or inflammation (arthritis), but also have enthesitis. Enthesitis is swelling or inflammation of the entheses, the connective tissue where tendons or ligaments attach to bone.</p> <p>Between 10% and 15% of all children with JIA have ERA. It is usually seen in late childhood or adolescence (eight to 15 years of age). It affects boys more often than girls.</p> <p>The severity of ERA can vary. For some children, it can be mild and last only a short time. For others, it can be more severe and last a long time. Some children may develop inflammation in their back when they are adults.</p> <p>ERA can also be called spondyloarthritis or ankylosing spondylitis.</p> <p>These diseases are managed by rheumatologists, doctors who specialize in diseases of the joints and inflammation.</p> <h2>Key points</h2> <ul> <li>ERA is a type of juvenile idiopathic arthritis (JIA).</li> <li>ERA is a disease that causes pain, swelling and stiffness in the joints of the hips, knees, ankles, feet and lower back.</li> <li>ERA is an autoimmune disease. We do not know why some people get ERA.</li> <li>People with ERA may also have inflammation in the eyes, skin or intestines.</li> <li>There are several steps to diagnose ERA and your child will need various tests.</li> <li>There are a variety of treatments to help with the pain and inflammation.</li> </ul> <h2>Signs and symptoms of enthesitis-related arthritis</h2><p>The arthritis in ERA is mainly in the lower limbs (hip, knee, ankle and foot). Arthritis in the back (spondylitis) and the base of the spine at the sacroiliac joint (sacroiliitis) is not as common at first, but can occur later. Children with spondylitis or sacroiliitis often complain of lower back or buttock pain that is worse with rest and better with activity. Arthritis can also occur in the upper limbs, especially the shoulders.</p> <figure class="asset-c-80"><span class="asset-image-title">Joints affected by enthesitis arthritis (ERA)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Joints_affected_by_ERA_MED_ILL_EN.jpg" alt="Lower joints that may be affected by ERA" /><figcaption class="“asset-image-caption”">Arthritis in the lower joints can be part of ERA. Some children have just the arthritis, some have just the enthesitis, some have a combination of both.</figcaption> </figure> <p>The most common areas affected by enthesitis are the knees, heels and bottom of the feet. As a result, children with enthesitis report heel, foot or knee pain, with or without swelling. To help with enthesitis pain in the foot and heel, your child’s health-care team may recommend supportive footwear and padded heel inserts for your child's shoes.</p><p>Symptoms of ERA can come and go. Sometimes your child may have a flare of their disease when there is more pain and swelling of joints and/or entheses.</p> <figure class="asset-c-80"><span class="asset-image-title">Entheses affected by enthesitis arthritis (ERA)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Entheses_affected_by_ERA_MED_ILL_EN.jpg" alt="Entheses in the lower half of the body" /><figcaption class="“asset-image-caption”">Entheses are where tendons and ligaments insert into bone. Enthesitis is inflammation of entheses.</figcaption> </figure> <h3>Possible other symptoms of ERA</h3><p>For some patients with ERA, inflammation can occur in other areas of the body as well. Not all children with ERA will have these symptoms, but doctors will always be checking for:</p><ul><li>Eye inflammation occurs in up to 30% of children who have ERA. It usually occurs in one eye and can reoccur. Inflammation occurs in the iris, where it is called acute anterior uveitis. The eye is usually red, painful and sensitive to light. Eye inflammation is an emergency. Your child will need to see an eye doctor (ophthalmologist) right away. Your child will need to have routine eye exams with a "slit lamp" to look for early signs of eye inflammation. Please speak to your child’s doctor about how often your child will need to have an eye exam.</li><li>Skin inflammation can also occur in children with ERA. Inflammation in the skin is called psoriasis. This is a persistent skin rash that looks like red patches covered with white scales. It can be found on the scalp, underarms, elbows and around the belly button.</li><li>Bowel inflammation can also occur in children with ERA. Inflammation in the bowel (intestines) is called inflammatory bowel disease (IBD). There are two types of IBD: Crohn's disease, and ulcerative colitis.</li></ul><h2>Diagnosis of enthesitis-related arthritis</h2> <p>There are several steps to diagnosing ERA. The doctor will ask you about your child's symptoms and medical history and will also do a physical exam to look for joint inflammation. They may suspect ERA when a child has joint pain and swelling, especially in the lower limbs; pain in the lower back or buttocks; or signs of enthesitis for more than six weeks. The doctor will usually order blood tests, X-rays and sometimes additional tests, like magnetic resonance imaging (MRI), to help diagnose the disease.</p> <p>One blood test that can be helpful when trying to diagnosis ERA is the HLA-B27 genetic marker. It can tell us who is at higher risk of developing ERA. Most children with ERA are "positive" for the HLA-B27 marker, but it is important to note that:</p> <ul> <li>Not every person who carries this marker will have ERA.</li> <li>A child can have ERA and still be "negative" for HLA-B27.</li> </ul> <h2>Treatment of enthesitis-related arthritis</h2> <p>ERA is treated with various types of medicine:</p> <ul> <li>Some medicine can improve symptoms of inflammation, helping to reduce pain and stiffness and improve movement in the joints.</li> <li>Some people with ERA need stronger medicine that suppresses the immune system and helps to control inflammation and prevent joint damage.</li> </ul> <p>Your child will be followed by a rheumatology team including doctors, nurses, physical therapists, social workers, dieticians and child life specialists. This team has a lot of experience treating children with ERA.</p> <p>For more information, please see <a href="/Article?contentid=1003&language=English">Juvenile enthesitis-related arthritis: Treatment</a>, <a href="/Article?contentid=14&language=English">Living with ERA</a>, <a href="/Article?contentid=1004&language=English">Exercises for enthesitis and arthritis</a> and <a href="/Article?contentid=15&language=English">Enthesitis-related arthritis: A guide for teenagers</a>.</p>
Enthésite en relation avec l'arthrite juvénile (ERA)EEnthésite en relation avec l'arthrite juvénile (ERA)Juvenile enthesitis-related arthritis (ERA)FrenchRheumatologyChild (0-12 years);Teen (13-18 years)Back;Knee;Ankle;Foot;HipImmune system;Ligaments;TendonsConditions and diseasesCaregivers Adult (19+)NA2016-08-12T04:00:00Z9.0000000000000052.0000000000000894.000000000000Health (A-Z) - ConditionsHealth A-Z<p>L'arthrite juvénile liée à l'enthésite comprend de l'enflure et de la douleur à l'endroit où les tendons, les ligaments rentrent dans l'os. Elle est plus fréquente chez les garçons que chez les filles.<br></p><h2>Qu’est-ce que l’arthrite idiopathique juvénile (AIJ)?</h2><p>L’arthrite idiopathique juvénile (AIJ) est une forme d’arthrite qui touche les enfants de moins de 16 ans. On l’appelle aussi l’arthrite infantile.</p><p>Par arthrite, on veut dire « enflure ou inflammation des articulations ». L’arthrite cause de la douleur, de l’enflure, des raideurs et la perte de mouvement dans les articulations. Le terme « idiopathique » signifie que nous n’en connaissons pas la cause.</p><h2>Qu’est-ce que l’enthésite en relation avec l’arthrite?</h2><p>Il existe de nombreux types d’arthrite. L’enthésite en relation avec l’arthrite (ERA) en est un. Chez les patients atteints de l’ERA, l’enflure ou l’inflammation (arthrite) est accompagnée d’enthésite. L’enthésite est une enflure ou inflammation de l’enthèse, la zone où les tendons et les ligaments s’ancrent à l’os.</p><p>Dix à 15 % des enfants atteints d’AIJ sont atteints d’ERA. L’ERA a tendance à se manifester plus tard dans l’enfance ou à l’adolescence (entre huit et 15 ans). Elle est plus fréquente chez les garçons que chez les filles.</p><p>La gravité de l’ERA peut varier. Chez certains enfants, elle peut être légère et de courte durée. Chez d’autres, elle peut être plus grave et durer longtemps. Une inflammation du dos peut se déclarer chez certains enfants à l’âge adulte.</p><p>On appelle aussi l’ERA la spondylarthrite ou la spondylite ankylosante.</p><p>Ces maladies sont prises en charge par des rhumatologues, des médecins qui se spécialisent dans les troubles des articulations et l’inflammation.<br></p><h2>À retenir</h2> <ul><li>L’ERA est un type d’arthrite idiopathique juvénile (AIJ).</li><li>L’ERA est une maladie qui cause de la douleur, de l’enflure et des raideurs. Elle touche les articulations des hanches, des genoux, des chevilles, des pieds et du bas du dos.<br></li><li>L’ERA est une maladie auto-immune. Nous ne savons pas pourquoi certaines personnes en sont atteintes.</li><li>Les personnes atteintes d’ERA peuvent aussi avoir des inflammations des yeux, de la peau et des intestins.</li><li>Il y a plusieurs étapes au diagnostic de l’ERA. Votre enfant devra subir divers examens.</li><li>Il y a une gamme de traitements contre la douleur et l’inflammation.</li></ul><h2>Signes et symptômes de l’ERA</h2><p>Dans les cas d’ERA, l’arthrite se situe principalement dans les membres inférieurs (la hanche, le genou, la cheville et le pied). L’arthrite du dos (spondylite) et des articulations sacro-iliaques (sacro-iliite), situées à la base de la colonne, est moins fréquente au début. Mais, elle peut survenir plus tard. Les enfants atteints de spondylite et de sacro-iliite peuvent se plaindre de douleurs au bas du dos ou aux fesses. La douleur empire avec le repos et s’améliore avec l’activité. L’arthrite peut aussi survenir dans les membres supérieurs, surtout dans les épaules.</p> <figure class="asset-c-80"> <span class="asset-image-title">Articulations touchées par l'ERA</span><img src="https://assets.aboutkidshealth.ca/akhassets/Joints_affected_by_ERA_MED_ILL_FR.jpg" alt="Les articulations inférieures qui pourraient être touchées par l'ERA" /><figcaption class="asset-image-caption">L'arthrite des articulations des membres inférieures fait partie de l'ERA. Certains enfants n'ont qu'une inflammation des articulations, d'autres, de l'enthèsite, et certains autres, une combinaison des deux.</figcaption> </figure> <p>Les sites les plus courants de l’enthésite sont les genoux, les talons et la plante des pieds. Par conséquent, les enfants rapportent une douleur aux talons, aux pieds ou aux genoux, avec ou sans enflure. Pour atténuer la douleur aux pieds et aux talons, l’équipe soignante peut recommander des souliers avec supports ou des coussins pour les talons à glisser dans les chaussures.<br></p><p>Les symptômes peuvent apparaître et disparaître. Parfois, l’enfant a des poussées actives quand il y a plus de douleurs et d’enflure dans les articulations ou les enthèses.</p> <figure class="asset-c-80"> <span class="asset-image-title">Enthèses touchées par l'ERA</span><img src="https://assets.aboutkidshealth.ca/akhassets/Entheses_affected_by_ERA_MED_ILL_FR.jpg" alt="Les enthèses situées dans la partie inférieure du corps" /><figcaption class="asset-image-caption">Les enthèses sont la zone d'insertion des tendons et des ligaments dans l'os. L'enthésite est une inflammation de l'enthèse.</figcaption> </figure> <h3>Autres symptômes possibles de l’ERA</h3><p>Dans certains cas d’ERA, l’inflammation peut se produire à d’autres endroits dans le corps. Ce ne sont pas tous les enfants atteints d’ERA qui auront ces symptômes, mais les médecins chercheront tout de même à en détecter la présence :</p><ul><li>Des inflammations aux yeux se produisent chez 30 % des enfants atteints d’ERA. Elles surviennent dans un œil et peuvent se reproduire. L’inflammation touche l’iris; on l’appelle uvéite antérieure aiguë. L’œil est rouge, douloureux et sensible à la lumière. L’inflammation des yeux est une urgence. Votre enfant devra consulter un ophtalmologiste (médecin des yeux) immédiatement. Il devra subir des examens réguliers des yeux sous une « lampe à fente » afin que les signes précoces d’une inflammation aux yeux soient dépistés. Veuillez discuter avec son médecin de la fréquence à laquelle votre enfant doit subir un examen.</li><li>La peau des enfants peut aussi être atteinte d’inflammation. On appelle l’inflammation de la peau le psoriasis. Il s’agit d’une éruption de lésions persistantes qui ressemblent à des taches rouges couvertes d’écailles blanches. Il peut y avoir des lésions sur le cuir chevelu, dans les aisselles, sur les coudes et autour du nombril.</li><li>Il peut aussi y avoir une inflammation des intestins chez les enfants atteints d’ERA. Il s’agit de maladies inflammatoires intestinales (MII). Il existe deux types de MII : la maladie de Crohn, qui touche l’intestin grêle, et la colite, qui touche principalement le gros intestin.</li></ul> <br><h2>Diagnostic de l’ERA</h2><p>Il y a plusieurs étapes au diagnostic de l’ERA. Le médecin vous posera des questions sur les symptômes de l’enfant et sur ses antécédents médicaux. Il fera aussi un examen physique pour voir si votre enfant présente des signes d’une inflammation dans les articulations. Il peut soupçonner l’ERA si votre enfant a des douleurs et de l’enflure dans les articulations, surtout dans les membres inférieurs, des douleurs au bas du dos ou aux fesses, ou des signes d’enthésite pendant plus de six semaines. Le médecin demande normalement des analyses sanguines, des radiographies et parfois d’autres tests, comme l’imagerie par résonnance magnétique (IRM), pour faciliter le diagnostic.</p><p>Tester la présence du marqueur génétique HLA-B27 dans le sang peut être utile pour porter un diagnostic d’ERA. Ce test sanguin indique qui est le plus à risque d’être atteint d’ERA. La plupart des enfants atteints ont un résultat positif pour le marqueur HLA-B27. Il convient cependant de noter que :</p><ul><li>les personnes qui ont ce marqueur ne sont pas toutes atteintes par la maladie;</li><li>un enfant peut être atteint d’ERA et avoir un résultat négatif au test du marqueur HLA-B27.<br></li></ul><h2>Traitement de l’ERA</h2><p>L’ERA se traite au moyen de divers médicaments :</p><ul><li>Certains médicaments peuvent améliorer les symptômes de l’inflammation. Ils aident à réduire la douleur et les raideurs et à améliorer l’amplitude des mouvements.</li><li>Certaines personnes atteintes d’ERA ont besoin de médicaments plus puissants qui diminuent les réactions du système immunitaire et aident à contrôler l’inflammation et à prévenir les dommages articulaires.</li></ul><p>Votre enfant sera suivi par une équipe de rhumatologie qui comprend des médecins, du personnel infirmier, des physiothérapeutes, des travailleurs sociaux, des diététistes et des éducateurs en milieu pédiatrique. L’équipe a beaucoup d’expérience dans le traitement des enfants atteints d’ERA.</p><p>Pour en savoir plus, veuillez consulter <a href="/Article?contentid=1003&language=French">Enthésite en relation avec l’arthrite juvénile : traitement</a>, <a href="/Article?contentid=14&language=French">Vivre avec l’ERA</a>, <a href="/Article?contentid=1004&language=French">Exercices pour l’enthésite et l’arthrite</a> et <a href="/Article?contentid=15&language=French">Enthésite en relation avec l’arthrite : un guide pour les adolescents</a>.<br></p>

 

 

 

 

Juvenile enthesitis-related arthritis (ERA)13.0000000000000Juvenile enthesitis-related arthritis (ERA)Juvenile enthesitis-related arthritis (ERA)JEnglishRheumatologyChild (0-12 years);Teen (13-18 years)Back;Knee;Ankle;Foot;HipImmune system;Ligaments;TendonsConditions and diseasesCaregivers Adult (19+)NA2016-08-12T04:00:00Z8.5000000000000056.80000000000001133.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Juvenile enthesitis-related arthritis includes swelling and pain where tendons and ligaments attach to bone. It affects more boys than girls.<br></p><h2>What is juvenile idiopathic arthritis (JIA)?</h2> <p>Juvenile idiopathic arthritis (JIA) is arthritis that affects children who are less than 16 years old. It is also called childhood arthritis.</p> <p>Arthritis means "joint swelling" or "joint inflammation." Arthritis leads to pain, swelling, stiffness and loss of motion in the joints. "Idiopathic" means that we do not know the cause.</p> <h2>What is enthesitis-related arthritis (ERA)?</h2> <p>There are many different types of arthritis. Enthesitis-related arthritis (ERA) is one type. Patients with ERA not only have joint swelling or inflammation (arthritis), but also have enthesitis. Enthesitis is swelling or inflammation of the entheses, the connective tissue where tendons or ligaments attach to bone.</p> <p>Between 10% and 15% of all children with JIA have ERA. It is usually seen in late childhood or adolescence (eight to 15 years of age). It affects boys more often than girls.</p> <p>The severity of ERA can vary. For some children, it can be mild and last only a short time. For others, it can be more severe and last a long time. Some children may develop inflammation in their back when they are adults.</p> <p>ERA can also be called spondyloarthritis or ankylosing spondylitis.</p> <p>These diseases are managed by rheumatologists, doctors who specialize in diseases of the joints and inflammation.</p> <h2>Enthesitis-related arthritis is an autoimmune disease</h2> <p>Inflammation (irritation and swelling) is a normal process in the body. It is how our immune system protects our bodies from bacteria and viruses that cause infection.</p> <p>In ERA, like other types of childhood arthritis, there is no infection. Instead, the immune system is confused and attacks the cells and tissues in the body’s connective tissues including the joints, tendons and entheses. This leads to redness, swelling, pain, warmth, stiffness or loss of movement in the connective tissue. For this reason, ERA is called an autoimmune disease. So far, we do not know what causes it. There is nothing that you did or did not do to cause your child’s ERA.</p> <h2>Key points</h2> <ul> <li>ERA is a type of juvenile idiopathic arthritis (JIA).</li> <li>ERA is a disease that causes pain, swelling and stiffness in the joints of the hips, knees, ankles, feet and lower back.</li> <li>ERA is an autoimmune disease. We do not know why some people get ERA.</li> <li>People with ERA may also have inflammation in the eyes, skin or intestines.</li> <li>There are several steps to diagnose ERA and your child will need various tests.</li> <li>There are a variety of treatments to help with the pain and inflammation.</li> </ul> <h2>Signs and symptoms of enthesitis-related arthritis</h2><p>The arthritis in ERA is mainly in the lower limbs (hip, knee, ankle and foot). Arthritis in the back (spondylitis) and the base of the spine at the sacroiliac joint (sacroiliitis) is not as common at first, but can occur later. Children with spondylitis or sacroiliitis often complain of lower back or buttock pain that is worse with rest and better with activity. Arthritis can also occur in the upper limbs, especially the shoulders.</p> <figure class="asset-c-80"><span class="asset-image-title">Joints affected by enthesitis arthritis (ERA)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Joints_affected_by_ERA_MED_ILL_EN.jpg" alt="Lower joints that may be affected by ERA" /><figcaption class="“asset-image-caption”">Arthritis in the lower joints can be part of ERA. Some children have just the arthritis, some have just the enthesitis, some have a combination of both.</figcaption> </figure> <p>The most common areas affected by enthesitis are the knees, heels and bottom of the feet. As a result, children with enthesitis report heel, foot or knee pain, with or without swelling. To help with enthesitis pain in the foot and heel, your child’s health-care team may recommend supportive footwear and padded heel inserts for your child's shoes.</p><p>Symptoms of ERA can come and go. Sometimes your child may have a flare of their disease when there is more pain and swelling of joints and/or entheses.</p> <figure class="asset-c-80"><span class="asset-image-title">Entheses affected by enthesitis arthritis (ERA)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Entheses_affected_by_ERA_MED_ILL_EN.jpg" alt="Entheses in the lower half of the body" /><figcaption class="“asset-image-caption”">Entheses are where tendons and ligaments insert into bone. Enthesitis is inflammation of entheses.</figcaption> </figure> <h3>Possible other symptoms of ERA</h3><p>For some patients with ERA, inflammation can occur in other areas of the body as well. Not all children with ERA will have these symptoms, but doctors will always be checking for:</p><ul><li>Eye inflammation occurs in up to 30% of children who have ERA. It usually occurs in one eye and can reoccur. Inflammation occurs in the iris, where it is called acute anterior uveitis. The eye is usually red, painful and sensitive to light. Eye inflammation is an emergency. Your child will need to see an eye doctor (ophthalmologist) right away. Your child will need to have routine eye exams with a "slit lamp" to look for early signs of eye inflammation. Please speak to your child’s doctor about how often your child will need to have an eye exam.</li><li>Skin inflammation can also occur in children with ERA. Inflammation in the skin is called psoriasis. This is a persistent skin rash that looks like red patches covered with white scales. It can be found on the scalp, underarms, elbows and around the belly button.</li><li>Bowel inflammation can also occur in children with ERA. Inflammation in the bowel (intestines) is called inflammatory bowel disease (IBD). There are two types of IBD: Crohn's disease, and ulcerative colitis.</li></ul><h2>Diagnosis of enthesitis-related arthritis</h2> <p>There are several steps to diagnosing ERA. The doctor will ask you about your child's symptoms and medical history and will also do a physical exam to look for joint inflammation. They may suspect ERA when a child has joint pain and swelling, especially in the lower limbs; pain in the lower back or buttocks; or signs of enthesitis for more than six weeks. The doctor will usually order blood tests, X-rays and sometimes additional tests, like magnetic resonance imaging (MRI), to help diagnose the disease.</p> <p>One blood test that can be helpful when trying to diagnosis ERA is the HLA-B27 genetic marker. It can tell us who is at higher risk of developing ERA. Most children with ERA are "positive" for the HLA-B27 marker, but it is important to note that:</p> <ul> <li>Not every person who carries this marker will have ERA.</li> <li>A child can have ERA and still be "negative" for HLA-B27.</li> </ul> <h2>Treatment of enthesitis-related arthritis</h2> <p>ERA is treated with various types of medicine:</p> <ul> <li>Some medicine can improve symptoms of inflammation, helping to reduce pain and stiffness and improve movement in the joints.</li> <li>Some people with ERA need stronger medicine that suppresses the immune system and helps to control inflammation and prevent joint damage.</li> </ul> <p>Your child will be followed by a rheumatology team including doctors, nurses, physical therapists, social workers, dieticians and child life specialists. This team has a lot of experience treating children with ERA.</p> <p>For more information, please see <a href="/Article?contentid=1003&language=English">Juvenile enthesitis-related arthritis: Treatment</a>, <a href="/Article?contentid=14&language=English">Living with ERA</a>, <a href="/Article?contentid=1004&language=English">Exercises for enthesitis and arthritis</a> and <a href="/Article?contentid=15&language=English">Enthesitis-related arthritis: A guide for teenagers</a>.</p>https://assets.aboutkidshealth.ca/AKHAssets/Juvenile_enthesitis-related_arthritis.jpghttps://assets.aboutkidshealth.ca/akhassets/Entheses_affected_by_ERA_MED_ILL_EN.jpgJuvenile enthesitis-related arthritis (ERA)False

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