Université Paris Est, Laboratoire d'Investigation Clinique (LIC) EA4393, AP-HP, Hôpital Henri-Mondor, Service de Santé Publique, Créteil, France.
Ann Rheum Dis. 2013 Jun;72(6):979-85. doi: 10.1136/annrheumdis-2012-201427. Epub 2012 Aug 14.
To assess whether the site of axial pain (thoracic spine, lumbar spine or buttock(s)) was associated with the site of MRI lesions in patients with recent inflammatory back pain (IBP) suggesting spondyloarthritis.
We conducted a cross-sectional study of baseline data in 708 patients with recent IBP from the DESIR cohort. Radiographs of the sacroiliac joints (SIJs) and MRI scans of the SIJs and thoracic and lumbar spine were obtained routinely. Associations between pain sites and sites of inflammatory and structural MRI changes were evaluated using separate multivariate logistic regressions.
Of the 648 patients with complete data, 61% had thoracic pain, 91.6% lumbar pain and 79.2% buttock pain. MRI inflammation was seen in 19%, 21% and 46% of patients at the thoracic, lumbar and SIJ sites, respectively. By multivariate analysis, pain was significantly associated with MRI inflammation only at the same site (adjusted OR (aOR)thoracic pain 1.71; 95% CI 1.09 to 2.67; p=0.02; aORlumbar pain 2.53; 95% CI 1.03 to 6.20; p=0.04; aORbuttock pain 2.86; 95% CI 1.84 to 4.46; p<0.0001). Pain site was not significantly associated with the site of structural MRI changes, except for buttock pain and SIJ structural MRI changes (aORbuttock pain 1.89; 95% CI 1.22 to 2.90; p=0.004). The association between pain site and site of MRI inflammation persisted in the subgroups with normal or doubtful SIJ radiographs or with Assessment of SpondyloArthritis international Society criteria for axial spondyloarthritis.
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.
评估近期炎症性背痛（IBP）患者的轴向疼痛部位（胸椎、腰椎或臀部）是否与 MRI 病变部位相关，这些患者提示患有脊柱关节炎。
我们对来自 DESIR 队列的 708 例近期 IBP 患者的基线数据进行了横断面研究。常规获得骶髂关节（SIJ）的 X 线片和 SIJ、胸腰椎的 MRI 扫描。使用独立的多变量逻辑回归评估疼痛部位与炎症和结构 MRI 变化部位之间的关联。
在 648 例具有完整数据的患者中，61%有胸背痛，91.6%有腰痛，79.2%有臀部痛。分别有 19%、21%和 46%的患者在胸、腰和 SIJ 部位出现 MRI 炎症。通过多变量分析，疼痛仅与同一部位的 MRI 炎症显著相关（调整后的比值比（aOR）：胸背痛 1.71；95%置信区间（CI）1.09 至 2.67；p=0.02；腰痛 2.53；95%CI 1.03 至 6.20；p=0.04；臀部痛 2.86；95%CI 1.84 至 4.46；p<0.0001）。除了臀部痛和 SIJ 结构 MRI 变化外，疼痛部位与结构 MRI 变化部位无显著相关性（aOR 臀部痛 1.89；95%CI 1.22 至 2.90；p=0.004）。在 SIJ 射线照相正常或可疑或符合评估脊柱关节炎国际协会轴性脊柱关节炎标准的亚组中，疼痛部位与 MRI 炎症部位之间的关联仍然存在。
近期 IBP 患者的疼痛部位（胸椎、腰椎或臀部）与同一部位的 MRI 炎症相关。
