Arthritis of the spine often overlooked in children

When kids or teens experience aching joints and stiffness it may be more than growing pains. It may be arthritis of the
spine and other joints (ankylosing spondylitis), which researchers report can often go undiagnosed for years and years,
leading to serious problems in adulthood. The findings, generated from a national life impact study and reported in the June
15 issue of Arthritis Care and Research, highlight a need for increased awareness and earlier treatment of the disease.



"Many children can have arthritis of the spine for years, but it can go overlooked and untreated," said Robert Warren, M.D.,
one of the publication authors, chief of rheumatology services at Texas Children's Hospital and associate professor of
pediatrics at Baylor College of Medicine. ""We need to diagnose their illnesses early and provide appropriate medications and
other therapy. With early diagnosis and proper treatment, a 13-year-old--who may otherwise go undiagnosed--can experience
significant relief of symptoms and potentially minimize or avoid disease-related disability later in life."


The life impact study was commissioned by the Spondylitis Association of America and involved more than 2,000 ankylosing
spondylitis (AS) patients. Results were collected from a mail survey distributed in 2002, which gathered a range of
information including analysis of work-related disability, functional impairment, self-reported quality of life and spinal
involvement. Results from the study were analyzed by a team of researchers led by Dr. Millicent Stone, University of Toronto.
In addition to a delay in diagnosis, the researchers report that adults with childhood onset disease experience more serious
physical deformity and work-related disability than those who develop the disease as adults.


"By surveying individuals with AS, we have learned that many people visit multiple doctors before receiving a diagnosis and
that adults with childhood onset disease experience much greater impairment during later life," said Jane Bruckel, executive
director and founder of the Spondylitis Association of America. "Arthritis of the spine strikes people very young in life and
is more prevalent than multiple sclerosis, cystic fibrosis and Lou Gehrig's disease combined. With new, effective medical
options available for AS, early diagnosis and proper medical care can have a significant impact on managing this disease."



While back pain is the primary symptom of AS in adults, children often experience other symptoms of the disease. Common
symptoms of juvenile onset AS can include:















-- Ongoing or recurrent joint pain, including neck or back pain

-- Pain around knees, bottom of feet and ankles

-- Pain and stiffness that is usually worse in the morning

-- Pain and stiffness that improves with exercise and worsens with immobility

-- Swelling in the joints or other areas of the body, including where ligaments like the Achilles tendon attaches to the
bone.


"It is common for children to experience 'growing pains,' but symptoms of joint aches and pains that last for weeks are
unusual," said Warren. "Parents who notice these symptoms in children should speak with their physician and determine if they
should see a pediatric rheumatologist. With early diagnosis and proper treatment, children with AS can experience significant
relief of symptoms and potentially impact the long-term effects of this disease."


About Ankylosing Spondylitis


Ankylosing Spondylitis (AS) is a painful and progressive form of spinal arthritis that typically develops in the late teens
and early twenties. It can result in fusing of the spine, hips and other joints, resulting in decreased mobility and, in
severe cases, a forward-stooped posture. AS can also affect the eyes, heart, lungs, kidneys and bowel. The Spondylitis
Association of America estimates that at least 500,000 people in the U.S. suffer from AS, but likely far more because the
disease is under recognized.


About the Spondylitis Association of America


The Spondylitis Association of America was the first, and remains the largest, resource in the U.S. for people affected by
spondylitis. For more than 20 years, the SAA has dedicated all of its resources to funding programs and research that
directly benefit the AS community. The SAA is a driving force in national research efforts to find the cure. For more
information on AS and the SAA, visit spondylitis or
call 800-777-8189.


About Texas Children's Hospital


Established in 1954 and located in the heart of the Texas Medical Center in Houston, Texas Children's Hospital is the largest
pediatric hospital in the nation. Out of 162 pediatric rheumatologists in practice across the country, Texas Children's
employs five in the subspecialty.


Contact: Jennifer Hart

jxharttexaschildrenshospital

832-824-2111

Texas Children's Hospital

texaschildrenshospital