Bodil Arnbak1,2, Tue S Jensen3,4, Niels Egund5, Anna Zejden5, Kim Hørslev-Petersen4,6, Claus Manniche3,4, Anne G Jurik3,4,5. 1. Research Department, Spine Centre of Southern Denmark, Hospital Lillebaelt, Oestre Hougvej 55, Middelfart, 5500, Denmark. bodil.arnbak@rsyd.dk. 2. Institute of Regional Health Research, University of Southern Denmark, Winsloewparken 19, Odense C, 5000, Denmark. bodil.arnbak@rsyd.dk. 3. Research Department, Spine Centre of Southern Denmark, Hospital Lillebaelt, Oestre Hougvej 55, Middelfart, 5500, Denmark. 4. Institute of Regional Health Research, University of Southern Denmark, Winsloewparken 19, Odense C, 5000, Denmark. 5. Department of Radiology, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark. 6. King Christian 10th Hospital for Rheumatic Diseases, Toldbogade 63, 6300, Gråsten, Graasten, Denmark.
Abstract
OBJECTIVE: To estimate the prevalence of degenerative and spondyloarthritis (SpA)-related magnetic resonance imaging (MRI) findings in the spine and sacroiliac joints (SIJs) and analyse their association with gender and age in persistent low back pain (LBP) patients. METHODS: Degenerative and SpA-related MRI findings in the whole spine and SIJs were evaluated in Spine Centre patients aged 18-40 years with LBP. RESULTS: Among the 1,037 patients, the prevalence of disc degeneration, disc contour changes and vertebral endplate signal (Modic) changes were 87 % (±SEM 1.1), 82 % (±1.2) and 48 % (±1.6). All degenerative spinal findings were most frequent in men and patients aged 30-40 years. Spinal SpA-related MRI findings were rare. In the SIJs, 28 % (±1.4) had at least one MRI finding, with bone marrow oedema being the most common (21 % (±1.3)). SIJ erosions were most prevalent in patients aged 18-29 years and bone marrow oedema in patients aged 30-40 years. SIJ sclerosis and fatty marrow deposition were most common in women. SIJ bone marrow oedema, sclerosis and erosions were most frequent in women indicating pregnancy-related LBP. CONCLUSION: The high prevalence of SIJ MRI findings associated with age, gender, and pregnancy-related LBP need further investigation of their clinical importance in LBP patients. KEY POINTS: • The location of vertebral endplate signal changes supports a mechanical aetiology. • Several sacroiliac joint findings were associated with female gender and pregnancy-related back pain. • Sacroiliac joint bone marrow oedema was frequent and age-associated, indicating a possible degenerative aetiology. • More knowledge of the clinical importance of sacroiliac joint MRI findings is needed.
OBJECTIVE: To estimate the prevalence of degenerative and spondyloarthritis (SpA)-related magnetic resonance imaging (MRI) findings in the spine and sacroiliac joints (SIJs) and analyse their association with gender and age in persistent low back pain (LBP) patients. METHODS: Degenerative and SpA-related MRI findings in the whole spine and SIJs were evaluated in Spine Centre patients aged 18-40 years with LBP. RESULTS: Among the 1,037 patients, the prevalence of disc degeneration, disc contour changes and vertebral endplate signal (Modic) changes were 87 % (±SEM 1.1), 82 % (±1.2) and 48 % (±1.6). All degenerative spinal findings were most frequent in men and patients aged 30-40 years. Spinal SpA-related MRI findings were rare. In the SIJs, 28 % (±1.4) had at least one MRI finding, with bone marrow oedema being the most common (21 % (±1.3)). SIJ erosions were most prevalent in patients aged 18-29 years and bone marrow oedema in patients aged 30-40 years. SIJ sclerosis and fatty marrow deposition were most common in women. SIJ bone marrow oedema, sclerosis and erosions were most frequent in women indicating pregnancy-related LBP. CONCLUSION: The high prevalence of SIJ MRI findings associated with age, gender, and pregnancy-related LBP need further investigation of their clinical importance in LBP patients. KEY POINTS: • The location of vertebral endplate signal changes supports a mechanical aetiology. • Several sacroiliac joint findings were associated with female gender and pregnancy-related back pain. • Sacroiliac joint bone marrow oedema was frequent and age-associated, indicating a possible degenerative aetiology. • More knowledge of the clinical importance of sacroiliac joint MRI findings is needed.
Entities:
Keywords:
Bone marrow; Low back pain; Magnetic resonance imaging; Sacroiliac joint; Spondyloarthritis
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