Musculoskeletal Involvement in Pediatric Behçet's Disease: A Single Center Experience

Background: Behçet’s disease (BD) is an inflammatory disease characterized by recurrent oral ulcers, genital ulcers, ocular manifestations, and vascular involvement. Musculoskeletal symptoms are common both at the time of presentation and throughout the course of BD, and similar symptoms are also observed in pediatric Behçet’s disease (PEDBD). This study aims to report the frequency and role of musculoskeletal involvement in PEDBD followed by our clinic. Method: This retrospective medical record review included a total of 90 patients diagnosed with PEDBD before the age of 16 years between January 2010 and December 2022. Results: Of the patients, 48 (53.3%) were female and 42 (46.7%) were male. Their mean age at diagnosis was 12.4 years. All patients (100%) had recurrent oral ulcers, while 55 (61.1%) had genital ulcers, 44 (48.9%) had musculoskeletal involvement, 37 (41.1%) had skin manifestations, 19 (21.1%) had ocular involvement, 17 (18.9%) had neurological involvement, and 17 (18.9%) had vascular involvement. Among the patients with joint involvement, 27 (65.9%) had arthritis, 41 (100%) had arthralgia, 37 (90.1%) had oligoarticular joint involvement, and 29 (70.7%) had unilateral involvement. The most commonly affected joints in the patients was in the knee (63.4%), followed by the ankle (31.7%), the wrist (19.5%), sacroiliac joints (14.6%), the hands (12.2%), the elbow (9.8%), and the feet (4.9%). Conclusions: Musculoskeletal symptoms are common in PEDBD and can be observed as an early sign of the disease at the time of diagnosis. Therefore, it is important to thoroughly inquire about possible BD in children with musculoskeletal symptoms.