Spondyloarthritis & psoriatic arthritis
Significant overlap of inflammatory and degenerative features on imaging among patients with degenerative disc disease, diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis: a real-life cohort study
Authors' conclusion
A significant overlap was found among DDD, DISH, and axSpA for inflammatory and degenerative imaging features. Particularly, SpA-like spine CR features were found in one-fourth of patients with DISH, and MRI BMO was found in one-third of those patients.
Study context
- Population
- Patients referred for low back pain (LBP) to a tertiary university rheumatology center (median age 62 years [IQR55–73], 63% males)
- Participants
- 136 patients
- Exposure
- Degenerative disc disease (DDD) vs diffuse idiopathic skeletal hyperostosis (DISH) vs axial spondyloarthritis (axSpA)
- DDDn = 71
- DISHn = 38
- axSpAn = 27
- Outcome
- Distribution of inflammatory and degenerative imaging features (SpA-like changes on CR and MRI of the spine; SIJ by New York criteria and MRI quadrants)
Methodological detailsretrospective, real-life cohort, tertiary university rheumatology center
- Retrospective
- Real-life cohort
- Tertiary university rheumatology center
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
SpA-like changes on CR, thoracic spine
SpA-like changes on CR, cervical spine
BMO on MRI, thoracic spine
Sacroiliitis (NY criteria)
| Outcome | DDD | DISH | axSpA |
|---|---|---|---|
| FL on MRI, thoracic spine | — not stated in the abstract | 56% | 52% |
| FL on MRI, lumbar spine | 65% | — not stated in the abstract | 74% |
— not stated in the abstract
- Sacroiliitis (NY criteria) — Overall
- 49%
SpA-like changes on conventional radiographs (CR), thoracic spine
- Significantly higher in DISH
SpA-like changes on CR, cervical spine
- Significantly higher in DDD
Bone marrow oedema (BMO) on MRI, thoracic spine
- Significantly higher in DISH
BMO on MRI, lumbar spine
- Equally distributed
- 35-42%
Fat lesions (FL) on MRI, thoracic spine
- Significantly more frequent in DISH and axSpA
FL on MRI, lumbar spine
- Significantly more frequent in DDD and axSpA
Degenerative changes
- Frequent in the three groups
Original publication
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