Windschall Daniel, Bork Hartmut, Gohar Faekah, Maier Anna
Klinik für Kinder- und Jugendrheumatologie, Rheumatologisches Kompetenzzentrum Nordwestdeutschland St. Josef-Stift-Sendenhorst, Westtor 7, 48324, Sendenhorst, Deutschland.
Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland.
Z Rheumatol. 2025 Jun;84(5):373-380. doi: 10.1007/s00393-025-01654-8. Epub 2025 May 9.
Although the knee joint in children and adolescents is most frequently affected in cases of juvenile idiopathic arthritis (JIA), shoulder joint arthritis is only present in a small proportion of JIA patients at disease onset. Shoulder joint involvement is more frequently seen in polyarthritis or chronic JIA, which if not considered and left untreated can lead to substantial joint immobility and with a destructive course. In addition to the clinical examination, imaging methods help to verify an early involvement of the shoulder joint and imaging can also provide important information in a treat to target concept. The treatment of pediatric omarthritis is very often guided by the treatment algorithm for the appropriate JIA category. In this respect, in addition to local steroid injections, medications such as methotrexate, biologicals and also Janus kinase (JAK) inhibitors are used. In addition to the pharmacotherapy, physiotherapy also plays an important role.
尽管在幼年特发性关节炎(JIA)病例中,儿童和青少年的膝关节最常受累,但在疾病发作时,只有一小部分JIA患者存在肩关节关节炎。肩关节受累在多关节炎或慢性JIA中更常见,如果不加以考虑和治疗,可能会导致严重的关节活动障碍,并伴有破坏性病程。除了临床检查外,影像学方法有助于证实肩关节的早期受累,并且影像学在目标治疗理念中也能提供重要信息。小儿多关节炎的治疗通常由适用于相应JIA类别的治疗算法指导。在这方面,除了局部注射类固醇外,还使用甲氨蝶呤、生物制剂以及 Janus激酶(JAK)抑制剂等药物。除了药物治疗外,物理治疗也起着重要作用。