Juvenile spondyloarthropathies are a group of HLA-B27–associated disorders and are associated with uveitis in 25% of affected individuals. Boys are more commonly affected than girls, and the disease onset is usually in early adolescence. There are differentiated and undifferentiated forms. Differentiated types include enthesitis-related arthritis, juvenile ankylosing spondylitis, juvenile psoriatic arthritis, reactive arthritis, and the arthritis associated with inflammatory bowel disease (enteropathic) (Table 24-4). A unifying feature of the differentiated forms is enthesitis, an inflammation of the sites where the ligaments, tendons, and joint capsules attach to bone. Enthesitis most commonly affects the insertions of the patellar ligament at the inferior patella, plantar fascia at the calcaneus, and the Achilles tendon. Asymmetric lower-extremity oligoarthritis with involvement of the hips and midfoot is highly suggestive of the disease.
The anterior uveitis associated with juvenile spondyloarthropathies usually has an acute onset with photophobia, pain, and a red eye.
Table 24-4 Types of Juvenile Spondyloarthropathies
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.