Enthesitis-Related Arthritis (ERA) Case Study: 16-Year-Old with Symmetric Hand Pain, Heel Pain & Back Stiffness | Pediatric Rheumatology 2025/2026

A comprehensive pediatric rheumatology case study for 2025/2026 on a 16-year-old male presenting with symmetric hand and wrist swelling, severe bilateral heel pain (enthesitis), inflammatory lower back pain, morning stiffness exceeding one hour, and a personal history of psoriasis and uveitis. This case explores the diagnostic criteria for Enthesitis-Related Arthritis (ERA), a subtype of Juvenile Idiopathic Arthritis (JIA), including the critical triad of peripheral arthritis, enthesitis, and axial involvement. Covers differential diagnosis from rheumatoid arthritis and reactive arthritis, HLA-B27 testing, MRI evaluation of sacroiliitis, fecal calprotectin for associated inflammatory bowel disease, and evidence-based management with NSAIDs, sulfasalazine, and anti-TNF biologic therapy. Emphasizes multidisciplinary care, physical therapy, and long-term monitoring. Ideal for advanced practice nurses, medical students, pediatric and rheumatology clinicians managing juvenile spondyloarthritis.