Challenging Pain in Knee and Ankle

  • Peter JandusEmail author


  • Enthesitis-related arthritis (ERA) necessitates presence of arthritis and/or enthesitis for at least 6 weeks in a child under 16 years of age

  • In the presence of enthesitis or arthritis alone, at least two of the following should be present to make a diagnosis of ERA: sacroiliac tenderness or inflammatory spinal pain, HLA-B27 positivity, onset of arthritis in boys aged >6 years, anterior uveitis associated with pain, redness, or photophobia, or a family history of HLA-B27-associated disease

  • NSAIDs are traditionally used as initial treatment of ERA

  • Methotrexate and biologic agents are reserved for patients who are refractory to NSAIDS


Enthesitis-related arthritis NSAIDs HLA-B27 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Immunology and Allergology, Department of MedicineUniversity Hospital and Medical FacultyGenevaSwitzerland

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