Treatment of Juvenile Enthesitis-Related Arthritis with Active Sacroiliitis
Children and adolescents with juvenile enthesitis-related arthritis (JIA) who have active sacroiliitis — established by MRI findings together with clinical signs or patient-reported inflammatory back pain — represent a specific clinical subgroup with a defined first-line treatment approach.
Active sacroiliitis is present when prior or current MRI findings consistent with sacroiliitis are accompanied by clinical examination findings — such as pain with direct palpation of the sacroiliac joints — and/or patient-reported symptoms of inflammatory back pain.
For this presentation, evidence-based guidance strongly supports initiating a specific class of anti-inflammatory medication as the first intervention. The full protocol — including clinical sequencing, selection criteria, and monitoring — is available via the link below.
References
DOI: 10.1002/acr.23870
For the purposes of this guideline, patients were considered to have active sacroiliitis if they had prior or current magnetic resonance imaging findings consistent with sacroiliitis along with clinical examination findings consistent with sacroiliitis (e.g., pain with direct palpation of the sacroiliac joints) and/or patient-reported symptoms of inflammatory back pain.
In children and adolescents with JIA and active sacroiliitis, treatment with an NSAID is strongly recommended over no treatment with an NSAID.
View source ↗