From the Royal National Hospital for Rheumatic Diseases, Bath; and Bristol Royal Hospital for Children, Bristol, UK.
J Rheumatol. 2013 Nov;40(11):1797-805. doi: 10.3899/jrheum.130542. Epub 2013 Sep 15.
Ankylosing spondylitis (AS) has 2 main modes of onset: juvenile-onset AS (JoAS) and adult-onset AS (AoAS). It is not known whether JoAS is a subtype of AS, or AS modulated by early age of onset and longer disease duration. We performed a systematic review of the literature, identifying 12 articles and 1 abstract directly comparing JoAS and AoAS cohorts, with observational study design. Patients with JoAS appear to have more peripheral joint involvement both clinically and radiographically (especially knees and ankles) and more root joint involvement (hips and shoulders); they are more likely to proceed to hip arthroplasty and often initially present with peripheral rather than axial symptoms. Patients with AoAS appear to have more axial symptoms and radiographic disease, particularly in the lumbar spine, and worse axial metrology. In terms of other characteristics, more evidence is needed to confidently state whether JoAS and AoAS are different.
强直性脊柱炎（AS）有两种主要发病模式：少年发病型强直性脊柱炎（JoAS）和成人发病型强直性脊柱炎（AoAS）。目前尚不清楚 JoAS 是 AS 的一个亚型，还是由发病年龄早和疾病持续时间长所调节的 AS。我们对文献进行了系统综述，确定了 12 篇文章和 1 篇摘要，这些文章和摘要直接比较了 JoAS 和 AoAS 队列，采用观察性研究设计。从临床和影像学上看（尤其是膝关节和踝关节），JoAS 患者外周关节受累更多，根关节受累（髋关节和肩关节）更多；他们更有可能进行髋关节置换术，而且通常最初表现为外周而非轴症状。AoAS 患者的轴症状和影像学疾病更多，特别是在腰椎，轴向计量学更差。就其他特征而言，需要更多的证据才能有把握地说明 JoAS 和 AoAS 是否不同。
