Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.


Assessment of Ankylosing Spondylitis Criteria in Chronic Low Back Pain Patients with Vertebral Endplate Modic 1 Signal Changes

Nguyen1,  Christelle, Bendeddouche1,  Imad, Sanchez1,  Katherine, Jousse1,  Marylène, Papelard1,  Agathe, Feydy2,  Antoine, Revel1,  Michel

Rehabilitation Department, Cochin Hospital, Paris-Descartes University, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France,
Department of Radiology B, Cochin Hospital, Paris-Descartes University, AP-HP

Purpose:

Chronic low back pain (CLBP) patients with vertebral endplate Modic 1 signal changes on lumbar magnetic resonance imaging (MRI) have been reported to display clinical features that could mimic back pain of inflammatory origin, especially back pain related to ankylosing spondylitis (AS). We aimed to assess whether CLBP patients with vertebral endplate Modic 1 signal changes on MRI fulfilled criteria for AS.

Method:

Between April and September 2008, all patients (n = 314) referred to a tertiary care physical medicine and rehabilitation department in France were consecutively screened. 185 hospitalized for common CLBP were prospectively assessed. Forty patients (13 males) fulfilling inclusion criteria were consecutively enrolled, and included in 2 groups according to the MRI findings (Modic 1, n = 15 and non-Modic 1, n = 25). MRI were assessed independently by a panel of 2 spine specialists and a radiologist. Human leukocyte antigen (HLA)-B27 antigen status was evaluated in one laboratory. Recording of clinical parameters, fulfilment of Amor (AC) and clinical and radiological modified New York criteria (mNYC) were performed. All assessors were blinded to HLA-B27 antigen status.

Results:

Whatever the Modic group, no patient fulfilled the AC and 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:

CLBP patients with Modic 1 vertebral endplate signal changes on lumbar MRI do not fulfil widely used and validated criteria sets for AS. CLBP associated with Modic 1 signal changes on lumbar MRI is a clinical entity distinct from AS.

To cite this abstract, please use the following information:
Nguyen, Christelle, Bendeddouche, Imad, Sanchez, Katherine, Jousse, Marylène, Papelard, Agathe, Feydy, Antoine, et al; Assessment of Ankylosing Spondylitis Criteria in Chronic Low Back Pain Patients with Vertebral Endplate Modic 1 Signal Changes [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1777
DOI: 10.1002/art.26851

Abstract Supplement

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