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Case Report
Online Published: 11 Dec 2024
 


Pubic symphysitis of enthesitis related arthritis mimicking urinary tract infection in a young boy

Neha Riswadkar, Rajoo Ramachandaran, Nidarshana Pandian, Mahesh Janarthanan.


Abstract
Enthesitis related arthritis (ERA) is a specific type of juvenile related arthritis (JIA) and ERA typically begins with enthesitis and peripheral arthritis in the lower extremities, progressing later in the disease to sacroiliitis and spinal involvement. The condition has a strong relationship with the HLA-B27 and primarily affects boys between the ages of 13 and 16 years. We describe an unusual presentation of ERA in a young boy with pubic pain and fever, describing its quintessential magnetic resonance imaging (MRI) findings. A child presented to the paediatric outpatient department with fever, insidious onset pubic pain and tenderness with associated leukocytosis and elevated inflammatory markers. MRI of the pelvis revealed bilateral symmetrical bone marrow edema involving the pubic symphysis and inferior pubic rami with para symphyseal edema involving bilateral obturator externus muscle and bilateral adductor longus muscle insertions suggestive of enthesitis of the pubic symphysis. MRI also showed sacroiliitis and enthesitis at other sites. HLA-B27 was positive. Patient responded well to short course of steroids and maintained remission with tumor necrosis factor (TNF) alpha inhibitors.

Key words: Pubic symphysitis; Enthesitis related arthritis; Urinary tract infection.


 
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How to Cite this Article
Pubmed Style

Riswadkar N, Ramachandaran R, Pandian N, Janarthanan M. Pubic symphysitis of enthesitis related arthritis mimicking urinary tract infection in a young boy. Sudan J Paed. 2024; 24(2): 164-169. doi:10.24911/SJP.106-1723696189

Web Style

Riswadkar N, Ramachandaran R, Pandian N, Janarthanan M. Pubic symphysitis of enthesitis related arthritis mimicking urinary tract infection in a young boy. https://sudanjp.com//?mno=215665 [Access: June 23, 2026]. doi:10.24911/SJP.106-1723696189

AMA (American Medical Association) Style

Riswadkar N, Ramachandaran R, Pandian N, Janarthanan M. Pubic symphysitis of enthesitis related arthritis mimicking urinary tract infection in a young boy. Sudan J Paed. 2024; 24(2): 164-169. doi:10.24911/SJP.106-1723696189


Vancouver/ICMJE Style

Riswadkar N, Ramachandaran R, Pandian N, Janarthanan M. Pubic symphysitis of enthesitis related arthritis mimicking urinary tract infection in a young boy. Sudan J Paed. (2024), [cited June 23, 2026]; 24(2): 164-169. doi:10.24911/SJP.106-1723696189


Harvard Style

Riswadkar, N., Ramachandaran, . R., Pandian, . N. & Janarthanan, . M. (2024) Pubic symphysitis of enthesitis related arthritis mimicking urinary tract infection in a young boy. Sudan J Paed, 24 (2), 164-169. doi:10.24911/SJP.106-1723696189


Turabian Style

Riswadkar, Neha, Rajoo Ramachandaran, Nidarshana Pandian, and Mahesh Janarthanan. 2024. Pubic symphysitis of enthesitis related arthritis mimicking urinary tract infection in a young boy. Sudanese Journal of Paediatrics, 24 (2), 164-169. doi:10.24911/SJP.106-1723696189


Chicago Style

Riswadkar, Neha, Rajoo Ramachandaran, Nidarshana Pandian, and Mahesh Janarthanan. "Pubic symphysitis of enthesitis related arthritis mimicking urinary tract infection in a young boy." Sudanese Journal of Paediatrics 24 (2024), 164-169. doi:10.24911/SJP.106-1723696189


MLA (The Modern Language Association) Style

Riswadkar, Neha, Rajoo Ramachandaran, Nidarshana Pandian, and Mahesh Janarthanan. "Pubic symphysitis of enthesitis related arthritis mimicking urinary tract infection in a young boy." Sudanese Journal of Paediatrics 24.2 (2024), 164-169. Print. doi:10.24911/SJP.106-1723696189


APA (American Psychological Association) Style

Riswadkar, N., Ramachandaran, . R., Pandian, . N. & Janarthanan, . M. (2024) Pubic symphysitis of enthesitis related arthritis mimicking urinary tract infection in a young boy. Sudanese Journal of Paediatrics, 24 (2), 164-169. doi:10.24911/SJP.106-1723696189




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