Helliwell P S, Zebouni L N, Porter G, Wright V
Rheumatology and Rehabilitation Research Unit University Department of Medicine, General Infirmary, Leeds.
Br J Rheumatol. 1993 Mar;32(3):216-21. doi: 10.1093/rheumatology/32.3.216.
Five hundred and three patients with RA were questioned about the symptom of back pain. Chronic back pain, lasting more than 3 months, occurred in 33 per cent of the group. A group of 100 back pain patients were studied in more detail using a structured questionnaire, clinical examination and radiology. Ninety-four of these patients had low back pain. Particular clinical patterns (such as that of the facet syndrome) were sought but no clear characteristics were found. Fifty-two lumbar spine X-rays were available from the RA population and these were compared to 52 age and sex matched X-rays from outpatients with chronic mechanical low back pain. Significant differences between these groups radiologically were a higher frequency of osteoporosis and a higher frequency of disc narrowing without associated osteophytes in the RA population. This study differs from previous reports which found other characteristic radiological features of RA of the lumbar spine (spondylolisthesis, facet erosions, and vertebral fracture), a discrepancy possibly resulting from the use of a control group having low back pain.
对503例类风湿关节炎（RA）患者进行了背痛症状调查。该组中33%的患者出现了持续超过3个月的慢性背痛。使用结构化问卷、临床检查和放射学方法，对一组100例背痛患者进行了更详细的研究。其中94例患者有下背痛。研究人员寻找了特定的临床模式（如小关节综合征），但未发现明确特征。从类风湿关节炎患者群体中获取了52份腰椎X线片，并将其与52份年龄和性别匹配的慢性机械性下背痛门诊患者的X线片进行比较。两组在放射学上的显著差异在于，类风湿关节炎患者群体中骨质疏松症的发生率更高，且椎间盘狭窄且无相关骨赘的发生率更高。本研究与之前的报告不同，之前的报告发现了腰椎类风湿关节炎的其他特征性放射学表现（椎体滑脱、小关节侵蚀和椎体骨折），这种差异可能是由于使用了有下背痛的对照组所致。
