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Title: Juvenile Onset Ankylosing Spondylitis Has Less Severe Spinal Course Than Adult-Onset Disease

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J Rheumatol 2002; 29: 1780-1785
09/06/2002 11:50:14 AM
By Andrew A. Skolnick

Juvenile onset ankylosing spondylitis has a less severe spinal disease course than adult onset ankylosing spondylitis. H.J. Baek and colleagues, at Seoul National University Hospital in Korea, studied 98 consecutive Korean patients with ankylosing spondylitis, who visited the rheumatology clinic of a tertiary referral centre. Forty-one cases were juvenile onset and 57 were adult onset. The researchers compared the clinical and radiographic features of the disease between the two groups. Median age of onset in patients with juvenile onset disease was 14 years (range 7 to 16 years) and 22 years in adult-onset patients (range 17 to 38 years). Patients with juvenile onset disease showed fewer spinal symptoms at presentation compared with the adult onset cases (41.5 percent vs. 80.7 percent). However, they had more frequent peripheral joint symptoms (73.2 percent vs. 36.8 percent), the researchers noted. Current cervical spine disease was more frequent in the adult onset group (66.7 vs. 43.9 percent), while current knee disease occurred more frequently in juvenile onset patients (26.8 vs. 8.8 percent). In addition, patients with juvenile onset disease showed a shorter tragus-wall distance, more mobility on the modified Schober test, greater chest expansion, and a better forced vital capacity than patients with adult onset disease, the investigators reported. Totally ankylosed sacroiliitis on radiographs was less frequently seen in juvenile onset patients than in adult onset patients (19.5 vs 47.4 percent). Spinal syndesmophyte was seen in 54.5 percent of adult onset cases, but only in 17.1 percent of juvenile onset patients. "Our data suggest that clinically and radiographically, juvenile onset ankylosing spondylitis has a less severe spinal disease course than adult onset ankylosing spondylitis," the researchers concluded.

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