RESEARCH - Radiological features of lumbar spinal lesions in patients with RA

[Guest guest]

Spine J. 2007 Jun 4 [Epub ahead of print]

Radiological features of lumbar spinal lesions in patients with

rheumatoid arthritis with special reference to the changes around

intervertebral discs.

Sakai T, Sairyo K, Hamada D, Higashino K, Katoh S, Takata Y, Shinomiya

F, Yasui N.

Department of Orthopedics, Institute of Health Biosciences, The

University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima

770-8503, Japan.

BACKGROUND CONTEXT: Compared with the cervical spine, little attention

has been paid to rheumatoid arthritis (RA)-related lumbar disorders.

Only a few articles have described the status of the lumbar spine

affected by RA based on plain X-ray films and magnetic resonance

imaging (MRI). PURPOSE: To describe the features and prevalence of

radiological changes of the lumbar spine of patients with RA and to

clarify the correlations of such features with disease activity. STUDY

DESIGN: Transverse radiological study. PATIENT SAMPLE: We

radiographically examined 104 patients with RA whose age ranged from

21 to 78 years (mean, 51.0). In each, the duration of RA exceeded 10

years (mean, 17.7 years). OUTCOME MEASURES: Clinical outcomes included

Ochi's classification, Lansbury index, C-reactive protein (CRP)

(mg/dL), rheumatoid factor (RF) (U/mL), and platelet (count/mm).

Radiological outcomes included radiography and MRI. METHODS: One

hundred four RA patients were included in this study regardless of the

presence/absence of low back pain. We examined discs from L1-2 to

L5-S, including endplates, in each patient on plain X-ray films and

magnetic resonance images and used a comprehensive grading system to

evaluate each feature of the lumbar spine affected by RA based on the

present findings and published reports. The correlations of these

radiological features with RA activity and Ochi's classification were

examined. To quantify disease activity, we determined the Lansbury

index, serum CRP (mg/dL), RF (U/mL), and platelet count (count/mm) at

the time of radiological examinations. RESULTS: Of the 104 patients,

47 (45.2%) exhibited a lumbar lesion. There were two types of lumbar

disc lesions related to RA: disc narrowing and disc ballooning. The

Lansbury index of patients with the most severe lesions was

significantly higher than that of patients with less severe lesions

(p<.01). The frequency of lumbar involvement also increased as the

number of affected peripheral joints increased, and Ochi's

classification appeared to be useful in predicting the occurrence of

lumbar lesions.

CONCLUSION: Of 104 patients, 47 (45.2%) exhibited abnormalities on

X-ray films and MRI. There were two types of disorders, disc narrowing

and disc ballooning. Both the Lansbury index and Ochi's classification

reflected the severity of lumbar lesions in RA patients.

PMID: 17606412

http://www.ncbi.nlm.nih.gov/pubmed/17606412

--

Not an MD

[Guest guest]

,

Thank you for this article. It is very interesting to me, since my

rheumy told me that my back pain was probably coming from osteo in the

spine. He said that RA affects just the neck, because there is no

synovial fluid in the other part of the spine.

I will have to show him this article. My pain flares up periodically,

and it seems that osteo would just hurt the same all the time. Last

week I had an awful time with it.

Sue

On Friday, August 15, 2008, at 06:02 PM, wrote:

>

> Radiological features of lumbar spinal lesions in patients with

> rheumatoid arthritis with special reference to the changes around

> intervertebral discs.

>

[Guest guest]

Thanks for finding this article. My last Lumbar MRI showed disc

degeneration, paracentral bulging and disc space narrowing at the

L5/S1 area. I guess this was just another physical confirmation of

the RA diagnosis and explains why I get zinged when I sit

down............Doreen

>

> Spine J. 2008 Jul-Aug;8(4):605-11. Epub 2007 Jun 4.

>

> Radiological features of lumbar spinal lesions in patients with

> rheumatoid arthritis with special reference to the changes around

> intervertebral discs.

>

> CONCLUSION: Of 104 patients, 47 (45.2%) exhibited abnormalities on

> X-ray films and MRI. There were two types of disorders, disc

> narrowing and disc ballooning. Both the Lansbury index and Ochi's

> classification reflected the severity of lumbar lesions in RA

> patients.

>

> PMID: 17606412

>

> http://www.ncbi.nlm.nih.gov/pubmed/17606412

> --

>

> Not an MD

>