| According to clinical study, child would have the same arthropathy as adult. But the study of child arthropathy was behind of the adult. As the result , some definitions of adult rheumatoid were used in child. Juvenile ankylosing spongdylitis(JAS) was one of the definitions. Adult ankylosing spondylitis (AS) is systemic inflammatory disease involved spine and sacroiliac joint while JAS is the disease which occurred before 16 years old. The clinical manifestations of Juvenile ankylosing spongdylitis are differed from adult. As adult, the first symptom is stiffness and pain in the back, while Juvenile ankylosing spongdylitis have arthritis of peripheral joints especially asymmetry arthritis in low limbs as the first manifestation. And it will be easily mistaked for tuberculosis of joints or juvenile rheumatoid arthritis. It will be 4 to 6 years from occurred to diagnose, and then delay diagnose and therapy, and induce crippledom. To adult ,the ratio of male and female is 3, but to child, the ratio is 10. Nowadays, the etiology of AS remains unknown, in 1973 which year Brewerton found the pertinency between AS and HLA-B27, and then many studies have conformed the striking association of As and HLA-B27. The rate of AS in family which HLA-B27 positive will be go up. As for JAS, it is very important to check HLA-B27, because the child of JAS have no back and kip pain in first time. If HLA-B27 is positive ,we will calculate the possibility of JAS. Nowadays, doctors diagnose it according to New York diagnose criterion, but the criterion is disbennifit for early diagnose as it insist the sacroiliac which were double and â…¡ degree or exceed â…¡ degree. In treatment, the medication is most important, including NSAIDs, CS, SAARDs, MTX, and COX-2 inhibitor, thalidomide, pamidronate et al. Although it was thought of a benigh disease, while according to the study abroad, its prognosis was bad. In our country, there were no report about early clinical manifestations and misdiagnosis.In order to analysis the early clinical manifestations and early diagnosis of JAS, to realize it earlier and to reduce the rate of disabled, we choosed 24 cases of JAS that have full case in our department and 6 cases of orthopaedics patients from January of 1994 to December of 2002, and had a retrospective analysis among of them. 8 cases(26.66%) had peripheral joints gall( including knee, ankle , finger, toe), 8 cases(26.66%) had coax pain, 5 cases had peripheral joints arthritis and coax pain, 4 cases(13.33%) had thews end inflammatory and thenar pain, 3 cases(10%) had stiffness and pain of back, 1 case(3.33%) had thenar pain and peripheral joints gall, 1 case(3.33%) has neck pain. There have 26 cases(86.67%) of HLA-B27 positive and 4 cases (13.33%) of HLA-B27 negative. 5 cases have been mistaken tuberculosis of bone joints, 4 cases have been mistaken juvenile rheumatoid arthritis (JRA), 1 case has been mistaken growth pain, 1 case has been mistaken myositis, 1 case has been mistaken Legg-Calve-Perthes disease, and 13 cases diagnosis were not clear. The rate of early misdiagnosis is 83.33%. 7 cases(23.33%) were catabatic, 10 cases (33.33%)were partly catabatic, 13 cases(43.34%) were disabled including 3 cases have been surgery. As the result, we think that the early clinical manifestations includes peripheral arthritis, coax pain, thews end inflammatory and thenar pain and stiffness and pain of back. It have been distinguished to tuberculosis of bone joints, JRA, growth pain and myositis et al. It have striking association between JAS and HLA-B27 which can be established by the rate(86.67%) of HLA-B27 positive in our study. According to the study of abroad and our experience, we think that checking HLA-B27 is more important in diagnosis of JAS than in adult AS.Conclusions: The early clinical manifestations of JAS includes peripheral arthritis, coax pain, thews end inflammatory and thenar pain and stiffness and pain of back. For its manifestations are atypical, doctors will easily make it misdiagnosed and delay therapy. To thos...
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