临床病史与寰枢外侧（C1-2）关节水肿相关。一项初步研究。
Clinical history correlates with lateral atlantoaxial (C1-2) joint edema. A pilot study.
作者信息
Levin Joshua, Kaufman Matthew, Yeung Gerald
机构信息
Department of Orthopaedic Surgery, Stanford University, 450 Broadway St, Pavilion C, 4th Floor, MC 6342, Redwood City, CA, 94063, USA.
Department of Neurosurgery, Stanford University, 450 Broadway St, Pavilion C, 4th Floor, MC 6342, Redwood City, CA, 94063, USA.
出版信息
Interv Pain Med. 2024 Sep 4;3(3):100434. doi: 10.1016/j.inpm.2024.100434. eCollection 2024 Sep.
BACKGROUND
Clinical evaluation in the determination of the etiology of axial spine pain is limited.
OBJECTIVE
To determine if a set of three features of the clinical history are indicative of C1-2 joint edema on MRI.
METHODS
All patients from one physician's practice who had axial cervical spine pain from 2021 to 2023 were evaluated. Cases were defined as those with all 3 of the ASL criteria, defined as Age >65, Superior cervical/suboccipital pain, and exacerbation of pain primarily by Lateral cervical spine rotation. Age-matched controls had axial cervical spine pain without meeting the ASL criteria. Edema around the atlantoaxial joint and/or odontoid was evaluated by STIR MR sequences.
RESULTS
The ASL criteria had a sensitivity of 82 % [95 % CI: 64-100 %], specificity of 79 %, [95 % CI: 63-95 %], positive predictive value of 74 % [95 % CI: 54-94 %], and negative predictive value of 86 % [95 % CI: 72-100 %] in diagnosing C1-2 joint edema.
CONCLUSION
A positive ASL criteria is sensitive and specific in the diagnosis of C1-2 joint edema, which may have clinical implications.
背景
临床评估在确定轴性脊柱疼痛病因方面存在局限性。
目的
确定一组临床病史的三个特征是否可通过MRI提示C1-2关节水肿。
方法
对2021年至2023年期间一位医生诊所中所有患有轴性颈椎疼痛的患者进行评估。病例定义为符合所有3项ASL标准的患者，ASL标准定义为年龄>65岁、上颈椎/枕下疼痛以及主要通过颈椎侧方旋转加重疼痛。年龄匹配的对照组患有轴性颈椎疼痛但不符合ASL标准。通过短TI反转恢复（STIR）MR序列评估寰枢关节和/或齿状突周围的水肿情况。
结果
ASL标准在诊断C1-2关节水肿时，灵敏度为82%[95%置信区间：64-100%]，特异度为79%[95%置信区间：63-95%]，阳性预测值为74%[95%置信区间：54-94%]，阴性预测值为86%[95%置信区间：72-100%]。
结论
ASL标准阳性在诊断C1-2关节水肿方面具有敏感性和特异性，可能具有临床意义。
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