title: From Modic 1 vertebral-endplate subchondral bone signal changes detected by MRI to the concept of 'active discopathy'.
abstract: Late-1980s MRI-detected vertebral-endplate subchondral bone signal changes associated with degenerative disc disease as well as recent studies suggest that in some patients, non-specific chronic low back pain (NS cLBP) can be defined by specific clinical, radiological and biological features, for a concept of active discopathy. This concept allows for associating a particular NS cLBP phenotype to a specific anatomical lesion, namely those with Modic 1 signal changes seen on MRI. Local inflammation is thought to play a pivotal role in these changes. Other etiopathogenic processes may include local infection and mechanical or biochemical stress combined with predisposing genetic factors; treatment strategies remain debated. Modic 1 changes detected by MRI can be considered a first biomarker in NS cLBP. Such changes are of high clinical relevance because they are associated with a specific clinical phenotype and can be targeted by specific treatments.
authors.affiliation: University of Paris Descartes, PRES Sorbonne Paris Cité, Service de rééducation et réadaptation de l'appareil locomoteur et des pathologies du rachis, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France University of Paris Descartes, PRES Sorbonne Paris, Cité Laboratoire de Pharmacologie, Toxicologie et Signalisation Cellulaire, INSERM UMR-S 1124, UFR Biomédicale des Saints Pères, Paris, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Nguyen
authors.affiliation: University of Paris Descartes, PRES Sorbonne Paris Cité, Service de rééducation et réadaptation de l'appareil locomoteur et des pathologies du rachis, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France University of Paris Descartes, PRES Sorbonne Paris, INSERM UMR-S 1153 et Institut fédératif de recherche sur le handicap, Paris, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Poiraudeau
authors.affiliation: University of Paris Descartes, PRES Sorbonne Paris Cité, Service de rééducation et réadaptation de l'appareil locomoteur et des pathologies du rachis, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France University of Paris Descartes, PRES Sorbonne Paris, Cité Laboratoire de Pharmacologie, Toxicologie et Signalisation Cellulaire, INSERM UMR-S 1124, UFR Biomédicale des Saints Pères, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Rannou
mesh_terms: D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000473:pathology*; D007405:Intervertebral Disc Displacement / Q000503:physiopathology; D017116:Low Back Pain / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000145:classification*; D013131:Spine / Q000473:pathology*; D013167:Spondylitis, Ankylosing / Q000473:pathology
keywords: Low Back Pain; Magnetic Resonance Imaging; Spondyloarthritis