Pediatria pre prax 5/2012

A diagnosis hidden in the eye, heel, small finger and the genes

Rheumatic diseases frequently have an insiduous onset and the full clinical picture may take a long time to develop. We present the case of a child who, during a long period of time, experieced the accumulation of characteristic, nonetheless, in general, less well known clinical symptoms of rheumatic disease – uveitis, enthesitis and dactylitis. Their intesity lead to expnesive and invasive diagnostic procedures, which did not contribute to the correct diagnosis. This was enabled only by complex evaluation of all symtoms and laboratory results. We discuss the characteristics and significance of the clinical findings in the presented case.

Keywords: enthesitis, uveitis, dactylitis, juvenile idiopathic arthritis.