title: Assessment of ankylosing spondylitis criteria in patients with chronic low back pain and vertebral endplate Modic I signal changes.
abstract: OBJECTIVE
  Patients with chronic low back pain (cLBP) and vertebral endplate Modic I signal changes on lumbar magnetic resonance imaging (MRI) have clinical features that could mimic inflammatory back pain related to spondyloarthritis (SpA) and/or ankylosing spondylitis (AS). We aimed to assess whether such patients fulfilled criteria for SpA and/or AS.
  
  
  METHODS
  For 5 months in 2008, all patients (n = 314) referred to a tertiary care physical medicine and rehabilitation facility in France were consecutively screened. A total of 185 hospitalized for non-specific cLBP were prospectively assessed. Forty patients fulfilling inclusion criteria were consecutively enrolled and included in 2 groups according to MRI findings: Modic I (n = 15) and non-Modic I (n = 25). MRI findings were assessed independently by 2 spine specialists and a radiologist. HLA-B27 status was determined. Data were collected on clinical measurements and fulfillment of Amor criteria (AC) and modified New York criteria (mNYC). All assessors were blinded to HLA-B27 status.
  
  
  RESULTS
  Whatever the Modic group, no patient fulfilled AC or mNYC, and mean total scores were comparable [3 ± 2 (range 0-22; p = 0.977), 1 ± 1 (range 0-3; p = 1.000), and 0 ± 0 (range 0-1; p = 1.000) for AC and clinical and radiological mNYC, respectively]. HLA-B27 status was similar in both groups [n = 2 (13%) vs n = 0 (0%); p = 0.135].
  
  
  CONCLUSIONS
  Patients with cLBP and Modic I vertebral endplate signal changes on lumbar MRI do not fulfill widely used and validated criteria for SpA and/or AS. Such cases are clinically distinct from SpA and AS.
authors: Paris Descartes University, France.
authors: Christelle
authors: C
authors: Nguyen
authors: Imad
authors: I
authors: Bendeddouche
authors: Katherine
authors: K
authors: Sanchez
authors: Marylène
authors: M
authors: Jousse
authors: Agathe
authors: A
authors: Papelard
authors: Antoine
authors: A
authors: Feydy
authors: Michel
authors: M
authors: Revel
authors: Serge
authors: S
authors: Poiraudeau
authors: François
authors: F
authors: Rannou
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D017116:Low Back Pain / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008161:Lumbosacral Region / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013167:Spondylitis, Ankylosing / Q000473:pathology*