Juvenile spondyloarthritis

Case contributed by Keshaw Kumar
Diagnosis almost certain

Presentation

Bilateral hip region and left knee joint pain for the last 6 months.

Patient Data

Age: 10 years
Gender: Female

MRI hip joints

mri
This study is a stack
Axial
T2
This study is a stack
Coronal
T2
This study is a stack
Coronal
T1
This study is a stack
Axial
STIR
This study is a stack
Coronal
STIR
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Info

There is edema in one of the muscles of the quadriceps femoris near its origin in the left proximal femur region, likely enthesitis.

Right sacroiliitis.

Knee

ultrasound
Longitudinal
Longitudinal
Transverse
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The ultrasound of the left knee joint reveals mild joint effusion and mild diffuse synovial thickening with minimal internal vascularity of power Doppler, suggesting active synovitis.

Case Discussion

The rheumatoid factor and ENA profile of the patient were negative, and HLA-B27 was positive. The ESR and CRP were high.

The patient had significant improvement in her symptoms after steroid therapy.

Co-author: Dr. Vivek Ranjan (pediatrician).

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