Calabro J J
Br J Rheumatol. 1983 Nov;22(4 Suppl 2):104-9. doi: 10.1093/rheumatology/xxii.suppl_2.104.
Ankylosing spondylitis (AS) is a heterogeneous and systemic rheumatic disorder that is characterized primarily by inflammation of the spine and sacroiliac joints. Consequently, back pain is a frequent presenting complaint although the disease can begin with peripheral arthritis as well as acute anterior uveitis. Unlike men, however, women appear to have milder or atypical AS that may go unrecognized for years. Moreover, the presentation in children rests on the recognition of two distinct subgroups that may be indistinguishable from juvenile chronic polyarthritis. The more frequent subgroup includes primarily teenage boys who present initially with an asymmetric peripheral pauciarthritis that most often affects lower-limb joints. Only some years later does sacroiliitis evolve, and, much later still, back complaints or other clinical and radiographic features typical of AS. A second subgroup includes mostly girls with a polyarticular onset that is subsequently characterized by cervical fusion, micrognathia, acute anterior uveitis, sacroiliitis, spondylitis, and rheumatoid-like hands that persist into adulthood.
强直性脊柱炎（AS）是一种异质性全身性风湿性疾病，主要特征为脊柱和骶髂关节炎症。因此，背痛是常见的就诊主诉，不过该疾病也可能始于外周关节炎以及急性前葡萄膜炎。然而，与男性不同，女性的强直性脊柱炎似乎症状较轻或不典型，可能多年都未被识别。此外，儿童强直性脊柱炎的表现取决于对两个不同亚组的认识，这两个亚组可能与青少年慢性多关节炎难以区分。较常见的亚组主要包括青少年男性，他们最初表现为不对称性少关节炎，最常累及下肢关节。骶髂关节炎几年后才会出现，而典型的强直性脊柱炎背痛或其他临床及影像学特征则出现得更晚。第二个亚组主要包括多关节起病的女孩，随后表现为颈椎融合、小颌畸形、急性前葡萄膜炎、骶髂关节炎、脊柱炎以及持续至成年期的类风湿样手部病变。
