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

[Guest guest]

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.

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

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Not an MD

[Guest guest]

So sorry about the pain, Sue.

Maybe an image of the area would be a good idea?

Not an MD

On Fri, Aug 15, 2008 at 5:55 PM, Sue <marysue@...> wrote:

> ,

>

> 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

[Guest guest]

Yes, , I think we'll eventually have to do that. At my last visit,

he was more concerned with the heart murmur and finding out its cause,

which was mild aortic valve regurgitation.

Sue

On Friday, August 15, 2008, at 06:52 PM, wrote:

> So sorry about the pain, Sue.

>

> Maybe an image of the area would be a good idea?

>

>