青少年型强直性脊柱炎的临床特征及影像学征象

目的分析青少年型强直性脊柱炎(JAS)的临床特征和影像学特点,提高JAS的诊断水平,减少致畸率;方法回顾性分析12例,前瞻性分析14例JAS临床特征和影像学征象。全部病例按美国风湿病协会诊断标准;其中前瞻性14例病例,10例初诊为Still's病,4例初诊为类风湿性关节炎,平均随诊2.3年;所有病例均行X线检查,18例行CT检查;8例行MRI检查。所有病例均累及下肢大关节,小关节不受累,仅1例累及上肢大关节。12例早期累及骶髂关节。其结果作卡方检验统计学处理。结果平均初诊年龄为9.3岁。发病起始年龄与病变程度有显著相关性,P<0.05,其进展较快,3例累及脊柱;发病病程长短与病变程度有显著的相关性,P<0.01。100%累及下肢大关节,累及关节数目平均为3.26个。结论JAS在临床和影像学上有其自身特征和规律。早期诊断,早期治疗可缓解疾病进程。

Clinical feature and imaging findings of juvenile ankylosing spondylitis

Objective To analyze the clinical features and imaging findings of juvenile ankylosing spondylitis (JAS) in order to improve the diagnosis and the prognosis of JAS. Methods Twelve cases were analyzed retrospectively and 14 cases , who were followed-up averagely for 2.3 years, were analyzed prospectively. Initially 10 were diagnosed as Still's disease and four were diagnosed as rheumatoid arthritis. Photography was performed in all cases, CT scan was done in 18 cases, and MRI in 8 cases. Lower extremity big joint disorders were observed in all cases and the small joints were reserved. The abnormalities of the sacroiliac joint were revealed in the early stage in 12 cases. The resulte were analyzed statistically. Results The age of preliminary diagnosis was 9.3 years in average. There were statistical correlation between the age of the first episode and severity of the disease. And there were statistical correlation between the course of the illness and severity of the disease. The large joints of the lower extremities were most commonly involved. Conclusion There were chraracteristic clinical features and imaging findings in the JAS. Early diagnosis and treatment improve the prognosis.