Joint disease and Schönlein-Henoch Purpura: a case review

Schönlein-Henoch purpura is the most common type of vasculitis in childhood. Its most frequent clinical manifestations are: palpable purpura, arthritis, abdominal pain, intestinal bleeding and nephritis although any organ may be affected. A large number of studies conclude that IgA plays a large role in its pathogenesis. It is more prevalent in males and the mean age of onset is at 6-7 years. Joint symptoms are the second most frequent manifestation, after palpable purpura. Joint involvement occurs in 40-82% of patients, being more frequent in children under 7 years. This may be the presenting symptom in 15-43%. Joint manifestations include arthritis and arthralgia. The affectation is usually oligoarticular. Pain is migratory and recurrent. The most involved joints are knees, ankles, feet and hips. The diagnosis is clinical and the therapeutic management is conservative, with nonsteroidal anti-inflammatory drugs at an early stage, requiring only corticosteroids if pain is intractable. Arthralgia-arthritis is transient and resolves within a few days without consequences. The recurrence rate of joint involvement is very low.