Artikel
The degree of bone marrow edema as detected by magnetic resonance imaging in the sacroiliac joints and the spine suspicious of axial spondyloarthritis in the general population is associated with different factors
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Autoren
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Xenofon Baraliakos
- Rheumazentrum Ruhrgebiet Herne, Ruhr Universität Bochum, Herne
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Adrian Richter
- Institute for Community Medicine, University Greifswald, Greifswald
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Daniel Feldmann
- Rheumazentrum Ruhrgebiet Herne, Ruhr Universität Bochum, Herne
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Anne Ott
- Rheumazentrum Ruhrgebiet Herne, Ruhr Universität Bochum, Herne
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Robin Buelow
- Department of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald
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Carsten Schmidt
- Institute for Community Medicine, University Greifswald, Greifswald
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Jürgen Braun
- Rheumazentrum Ruhrgebiet Herne, Ruhr Universität Bochum, Herne
| Veröffentlicht: | 9. September 2020 |
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Gliederung
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Introduction: We here identify and compare factors associated with the extension of magnetic resonance imaging (MRI) lesions in the spine and the SIJ suggestive of axial spondyloarthritis (axSpA) in the general population.
Methods: Spinal- (sagittal T1/T2 sequences) and SIJ- (semicoronal STIR sequences) MRIs were evaluated by two trained readers blinded to clinical data. BME (SIJ and spine) suggestive of axSpA were recorded. Degenerative lesions were excluded. The association of age sex, HLA-B27 and hsCRP positivity, smoking (ever smoker vs. no smoker), spinal pain (yes vs. no in last 3 months), body mass index (BMI) categories (WHO definition), physically demanding job, and giving birth within the last 12 month with the severity of BME were examined. Associations between clinical factors and the Berlin MRI score were analyzed by negative binomial regression models resulting in incidence rate ratios (IRRs).
Results: MRIs of 793 volunteers from the general population, mean age 37.3±6.3 years, 49.4% male, 8.9% HLA B27+, 7% CRP-positive, 56.9% with back pain in the last 3 months (28.8% with back pain NRS ≥4/10), 35.7% reported physically heavy work, 55% with BMI > 25 kg/m2, 16.2% current smokers, and 5% of females with pregnancy in the last year before MRI examination, were evaluated.
For BME on SIJ-MRIs, significant associations (IRR, 95% confidence level) were found for pregnancy in the last year (3.82, 1.17-14.24), HLA-B27+ (2.42, 1.33-4.55), BMI (25-30 vs. <25; 2.09 (1.33-3.31)) and chronic back pain (1.54, 1.02-2.33).
For BME on spinal MRIs, significant associations were found for age per decade increase (1.45, 1.10-1.91) and physically demanding work (1.45, 1.04-2.00). Overall, spinal BME was more frequent than SIJ BME in the participants working at a desktop (61.5% vs. 54.4%), respectively.
Conclusion: In this population-based study, individuals aged <45 years, HLA-B27+, women with pregnancy in the last year and presence of back pain were associated with the extent of BME in the SIJ, while age and physically demanding work were associated with the extent of BME in the spine. These data support the hypothesis of a mechanic origin of BME, while HLA B27 is a severity but not a susceptibility factor for BME in the SIJ.
Disclosures: None declared
