Spontaneous Atlantoaxial Subluxation as a Presenting Manifestation of Juvenile Ankylosing Spondylitis

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Abstract
Juvenile-onset ankylosing spondylitis is an unusual disorder which can present with peripheral arthritis or with more classic hip girdle and back symptoms. Atlantoaxial instability has been recognized as a late complication in only 1 patient and has not been reported as an early manifestation. A boy who presented with atlantoaxial instability and neck pain without neurologic involvement is discussed. Laboratory and clinical features of juvenile ankylosing spondylitis are discussed, along with the importance of qualitative sacroiliac joint scintigraphy in the diagnosis of early or confusing cases.

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