Aseptic discitis in patients with ankylosing spondylitis: a retrospective study of 14 cases

Langlois, Sandrine; Cedoz, Jean Pierre; Lohse, Anne; Toussirot, Éric; Wendling, Daniel

doi:10.1016/j.jbspin.2004.05.015

Cited by 46 publications

(44 citation statements)

References 8 publications

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“…The frequency of aseptic discitis in patients with AS is probably overestimated as a result of inclusion of degenerative lesions but also because of exclusion bias. The prevalence of destructive lesions varies between 1% and 28% (2,3). In spite of the findings in our patient, the positive predictive value of 18F-NaF PET for diagnosing spondyloarthritis or predicting a response to TNF antagonist therapy seems to be inconsistent (4).…”

Section: Radiological Vignettecontrasting

confidence: 68%

Aseptic HLA B27-positive spondylodiscitis: decreased 18F-FDG uptake after etanercept treatment

et al. 2016

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summaryWe observed a 69-year old man suffering from HLA B27 ankylosing spondylitis with persistent night back pain. 18F-FDG-PET/CT showed an increased metabolism at the level of the spinal space of L2-L3, L3-L4 with increased uptake compatible with spondylodiscitis. He started therapy with etanercept 50 mg/week. After six months of treatment repeated testing showed no uptake of the discs and vertebral bodies.

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Section: Radiological Vignettecontrasting

confidence: 68%

Aseptic HLA B27-positive spondylodiscitis: decreased 18F-FDG uptake after etanercept treatment

et al. 2016

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“…In all these cases, consensus was obtained without difficulties by authors 1 and 5. A total of 60 papers were excluded after review; 27 as they dealt with specific LBP conditions ( Table 2) and 33 for other reasons: one review article [55], four case reports [7,27,129,148], one double publication [90], one of two studies reporting data from the same study sample [80], ten for evaluating signal changes other than those related to the endplate [6,20,51,53,71,113,116,139,146,150], and eight articles because they did not report the exact numbers needed to calculate the prevalence rates of VESC [4,10,109,110,114,122,133,141]. Finally, eight articles were excluded because the study samples were selected on the basis of the presence of VESC [41, 50,56,63,68,134,137,149].…”

Section: Review Processmentioning

confidence: 99%

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

Jensen

Karppinen

Sorensen³

et al. 2008

Eur Spine J

391

297

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The prevalence of ''vertebral endplate signal changes'' (VESC) and its association with low back pain (LBP) varies greatly between studies. This wide range in reported prevalence rates and associations with LBP could be explained by differences in the definitions of VESC, LBP, or study sample. The objectives of this systematic critical review were to investigate the current literature in relation to the prevalence of VESC (including Modic changes) and the association with non-specific low back pain (LBP). The MEDLINE, EMBASE, and SveMED databases were searched for the period 1984 to November 2007. Included were the articles that reported the prevalence of VESC in non-LBP, general, working, and clinical populations. Included were also articles that investigated the association between VESC and LBP. Articles on specific LBP conditions were excluded. A checklist including items related to the research questions and overall quality of the articles was used for data collection and quality assessment. The reported prevalence rates were studied in relation to mean age, gender, study sample, year of publication, country of study, and quality score. To estimate the association between VESC and LBP, 2 9 2 tables were created to calculate the exact odds ratio (OR) with 95% confidence intervals. Eighty-two study samples from 77 original articles were identified and included in the analysis. The median of the reported prevalence rates for any type of VESC was 43% in patients with non-specific LBP and/or sciatica and 6% in non-clinical populations. The prevalence was positively associated with age and was negatively associated with the overall quality of the studies. A positive association between VESC and non-specific LBP was found in seven of ten studies from the general, working, and clinical populations with ORs from 2.0 to 19.9. This systematic review shows that VESC is a common MRI-finding in patients with non-specific LBP and is associated with pain. However, it should be noted that VESC may be present in individuals without LBP.

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“…Using these methods, spinal or sacroiliac joint inflammatory lesions (anterior spondylitis, spondylodiscitis or sacroiliitis, respectively) were evidenced in AS or SpA patients. For instance, enhancement of the contrast agent, gadolinium, was observed in the disc and the adjacent vertebral plates in spondylodiscitic lesions [17,18]. Dynamic MRI allows detection of early sacroiliitis in SpA patients in whom abnormalities are not revealed by conventional radiography [16].…”

Section: How To Assess the Diseasementioning

confidence: 99%

Bisphosphonates as anti-inflammatory agents in ankylosing spondylitis and spondylarthropathies

Toussirot¹,

Wendling²

2005

Expert Opinion on Pharmacotherapy

Self Cite

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NSAIDs remain the cornerstone of the treatment of ankylosing spondylitis (AS) and spondylarthropathies (SpA), and have been successfully used for a long time in these diseases. However, some patients remain refractory or intolerant to NSAIDs and new effective treatments have recently emerged, namely TNF-alpha-blocker agents. Other therapeutic options targeting the bone, such as bisphosphonates, have also been tried in refractory AS or SpA patients. The anti-inflammatory properties of bisphosphonates give the rationale for the use of these compounds in AS and SpA, and include the inhibition of antigen presenting cells, the modulation of pro-inflammatory cytokine generation, and also a decreased bone mass in AS. Open trials using pamidronate gave favourable results, and one controlled study comparing the efficacy of pamidronate 10 versus 60mg showed that the 60mg dose was effective in AS. Further studies are required to confirm these preliminary data and to better determine the optimal regimen (dosage and rhythm) of administration.

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Aseptic discitis in patients with ankylosing spondylitis: a retrospective study of 14 cases

Cited by 46 publications

References 8 publications

Aseptic HLA B27-positive spondylodiscitis: decreased 18F-FDG uptake after etanercept treatment

Aseptic HLA B27-positive spondylodiscitis: decreased 18F-FDG uptake after etanercept treatment

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

Bisphosphonates as anti-inflammatory agents in ankylosing spondylitis and spondylarthropathies

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