RT Journal Article
SR Electronic
T1 Assessment of Ankylosing Spondylitis Criteria in Patients with Chronic Low Back Pain and Vertebral Endplate Modic I Signal Changes
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 2334
OP 2339
DO 10.3899/jrheum.100165
VO 37
IS 11
A1 CHRISTELLE NGUYEN
A1 IMAD BENDEDDOUCHE
A1 KATHERINE SANCHEZ
A1 MARYLÈNE JOUSSE
A1 AGATHE PAPELARD
A1 ANTOINE FEYDY
A1 MICHEL REVEL
A1 SERGE POIRAUDEAU
A1 FRANÇOIS RANNOU
YR 2010
UL http://www.jrheum.org/content/37/11/2334.abstract
AB Objective. Patients with chronic low back pain (cLBP) and vertebral endplate Modic I signal changes on lumbar magnetic resonance imaging (MRI) have clinical features that could mimic inflammatory back pain related to spondyloarthritis (SpA) and/or ankylosing spondylitis (AS). We aimed to assess whether such patients fulfilled criteria for SpA and/or AS. Methods. For 5 months in 2008, all patients (n = 314) referred to a tertiary care physical medicine and rehabilitation facility in France were consecutively screened. A total of 185 hospitalized for non-specific cLBP were prospectively assessed. Forty patients fulfilling inclusion criteria were consecutively enrolled and included in 2 groups according to MRI findings: Modic I (n = 15) and non-Modic I (n = 25). MRI findings were assessed independently by 2 spine specialists and a radiologist. HLA-B27 status was determined. Data were collected on clinical measurements and fulfillment of Amor criteria (AC) and modified New York criteria (mNYC). All assessors were blinded to HLA-B27 status. Results. Whatever the Modic group, no patient fulfilled AC or mNYC, and mean total scores were comparable [3 ± 2 (range 0–22; p = 0.977), 1 ± 1 (range 0–3; p = 1.000), and 0 ± 0 (range 0–1; p = 1.000) for AC and clinical and radiological mNYC, respectively]. HLA-B27 status was similar in both groups [n = 2 (13%) vs n = 0 (0%); p = 0.135]. Conclusion. Patients with cLBP and Modic I vertebral endplate signal changes on lumbar MRI do not fulfill widely used and validated criteria for SpA and/or AS. Such cases are clinically distinct from SpA and AS.