Radiologic findings of the lumbar spine in patients with rheumatoid arthritis, and a review of pathologic mechanisms.
We have analyzed the radiologic findings on the lumbar spine and the clinical symptoms in patients with rheumatoid arthritis (RA). A total of 106 patients who fulfilled the revised criteria of the American Rheumatism Association were subjected. All of the patients were asked to fill out a questionnaire about the existence of low back pain, leg pain, and leg numbness. Radiologic features of the lumbar spine, including scoliosis, spondylolisthesis, disc space narrowing, endplate erosion, osteophyte, and osteoporosis, were checked. Radiographs of the cervical spine were also taken. The clinical background of RA, such as mutilating disease or not, was assessed. Forty-two patients (40%) had the symptoms of low back pain. Abnormal radiologic findings in lumbar spine were detected in 57%. The prevalence of clinical symptoms tended to be higher in the patients with endplate erosion. Forty-two percent of the patients had both lumbar and cervical lesions. The prevalence of lumbar lesion was not high in the mutilating type of RA, except for facet erosion and severe osteoporosis. The patients with pulse steroid therapy revealed a higher prevalence of vertebral fracture. From these results, we concluded that lumbar lesions were frequently observed in patients with RA. The possibility of lumbar lesions as well as the lesions in the cervical spine and peripheral joints should be examined in patients with RA.
Kawaguchi
Yoshiharu
Y
Department of Orthopaedic Surgery, Toyama Medical and Pharmaceutical University, Japan. zenji@ms.toyama-mpu.ac.jp
Matsuno
Hiroaki
H
Kanamori
Masahiko
M
Ishihara
Hirokazu
H
Ohmori
Kazuo
K
Kimura
Tomoatsu
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D015995:Prevalence; D011859:Radiography; D016037:Single-Blind Method; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology*