Does the site of magnetic resonance imaging abnormalities match the site of recent-onset inflammatory back pain? The DESIR cohort

Abstract

The site of pain (thoracic spine, lumbar spine or buttock(s)) is associated with MRI inflammation at the same site in patients with recent IBP.

Is the Site of Back Pain Related to the Location of Magnetic Resonance Imaging Lesions in Patients With Chronic Back Pain? Results From the Spondyloarthritis Caught Early Cohort

“…To our knowledge there is only 1 other study in which the relationship between the localization of pain and axial SpA lesions on MRI was investigated, and the findings partly matched the findings in our study. As we found in this study, Blachier et al found an association between buttock pain and inflammatory and structural MRI‐SI lesions, but with higher ORs of 2.86 and 1.89, respectively . Unfortunately, the readers in that study did not differentiate among types of structural lesions, so it is unclear what type(s) of structural lesion(s) were associated with buttock pain.…”

“…For clinicians, it is relevant to know whether there is a true relationship between MRI lesions, either due to axial SpA or to degenerative changes, and pain localized at the same site. Two previous studies investigated the possibility of an association between the location of MRI lesions and the site of pain . However, neither of these studies investigated this association in an early chronic back pain cohort nor combined the data on axial SpA–associated lesions and degenerative lesions.…”

EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice

“…summarises and presents the results of longitudinal20 21 50 52–54 61 63 64 66–69 71 73 74 76 as well as cross-sectional51 59 60 70 79 studies evaluating correlation with accepted disease activity parameters (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)) or pain.…”

Is Bony Evidence of Enthesial Reaction Sufficient for Differential Diagnosis?

“…MRI similarly reveals significantly less evidence of enthesitis than clinical examination, finding less than half the sites identified by the latter [47,49]. Intriguingly, enthesial sites were previously noted not to overlap when MRI and clinical localization were compared [50]. The differential diagnostic value of enthesitis thus may be more dependent on soft tissue findings than on actual osseous alterations.…”