Progress in the diagnosis and treatment of reactive arthritis in children
Reactive arthritis(ReA)is a kind of sterile,non-purulent arthritis that occurs after microbial infections far from the joints.The disease has a broad spectrum,and it can be classified into three categories based on clinical characteristics:human leukocyte antigen B27(HLA-B27)-associated ReA,acute rheumatic fever(ARF),and post-streptococcal reactive arthritis(PSRA).In addition to joints,it may also involve the gastrointestinal tract,skin,eyes,and heart.Unlike adults,the pathogenesis of ReA in children is more complex.HLA-B27-associated ReA is more common after gastrointestinal and respiratory infections,with less involvement of the central axis and sacroiliac joints and more involvement of the hip and peripheral joints and attachment point inflammation.ARF is most common in children aged 5 to 15 years,characterized by migratory and multiple arthritis.The duration of onset of PSRA in children is shorter than that in adults.This article reviews the epidemiology,clinical manifestations,diagnosis and treatment of ReA in children to improve clinicians'understanding of ReA in children.