title: Quantification of Bone Marrow Edema by Magnetic Resonance Imaging Only Marginally Reflects Clinical Neck Pain Evaluation in Rheumatoid Arthritis and Ankylosing Spondylitis.
abstract: Neck pain is common in rheumatoid arthritis (RA) and ankylosing spondylitis (AS). We investigated the correlation of bone marrow edema (BME) on magnetic resonance imaging (MRI) in RA and AS and its association with clinical complaints of neck pain.
  
  
  
  Cervical spine short-tau inversion recovery-MRI and T1w-MRI of 34 patients with RA and 6 patients with AS complaining about neck pain were obtained. Clinical and laboratory data were available. BME was scored by 2 blinded readers using a modification of a published score, including various cervical sites. Degenerative changes were also quantified.
  
  
  
  Patients were predominantly women (82.5%), and mean ± SD age was 57.5 ± 11.8 years, C-reactive protein (CRP) was 0.8 ± 1.3 mg/dl, and pain score was 46.0 ± 17.5. BME was detected in 24/40 patients (60%) involving the atlantoaxial region (21%), vertebral bodies (75%), facet joints (29%), and spinous processes (46%). Degenerative changes were identified in 21/40 patients (52.5%), 13 (62%) of whom also had BME in vertebral bodies. No differences were found between patients with versus without cervical BME for clinical assessments: numeric rating scale pain (median ± interquartile range) 5.5 ± 3.0 vs 6.0 ± 4.0 (p = 0.69), Funktionsfragebogen Hannover 68.2 ± 41.0 vs 42.0 ± 55.5 (p = 0.19), Northwick pain score 44.4 ± 21.8 vs 47.2 ± 27.0 (p = 0.83), or CRP 0.40 ± 0.80 vs 0.60 ± 0.66 (p = 0.94). For patients with degenerative changes, symptom duration was longer than for patients without (10 ± 12.5 vs 5.0 ± 18.0 yrs, p = 0.73).
  
  
  
  In this small study of patients with RA and AS complaining about neck pain, BME was found in many different cervical sites, including the facet joints and the spinous processes. However, the occurrence and severity of BME did not correlate with the severity of neck pain.
authors.affiliation: From the Rheumazentrum Ruhrgebiet, Herne; German Rheumatism Research Center, Berlin; Rheumatology Practice, Gladbeck; Rheumatology Practice, Hattingen; Rheumatology Practice, Bochum; Rheumatology Practice, Ruhr, Germany; Departments of Rheumatology, and Counties Manukau District Health Boards; Department of Rheumatology, University of Auckland, Auckland, New Zealand. baraliakos@me.com.|X. Baraliakos, MD, Rheumazentrum Ruhrgebiet; F. Heldmann, MD, Rheumazentrum Ruhrgebiet; J. Callhoff, MD, German Rheumatism Research Center; R. Suppiah, MD, Departments of Rheumatology, and Counties Manukau District Health Boards; F.M. McQueen, MD, Department of Rheumatology, University of Auckland; D. Krause, MD, Rheumatology Practice; C. Klink, MD, Rheumatology Practice; E. Schmitz-Bortz, MD, Rheumatology Practice; M. Igelmann, MD, Rheumatology Practice; L. Kalthoff, MD, Rheumatology Practice; U. Kiltz, MD, Rheumazentrum Ruhrgebiet; A. Schmuedderich, MD, Rheumazentrum Ruhrgebiet; J. Braun, MD, Rheumazentrum Ruhrgebiet. baraliakos@me.com.
authors.forename: Xenofon
authors.initials: X
authors.lastname: Baraliakos
authors.affiliation: From the Rheumazentrum Ruhrgebiet, Herne; German Rheumatism Research Center, Berlin; Rheumatology Practice, Gladbeck; Rheumatology Practice, Hattingen; Rheumatology Practice, Bochum; Rheumatology Practice, Ruhr, Germany; Departments of Rheumatology, and Counties Manukau District Health Boards; Department of Rheumatology, University of Auckland, Auckland, New Zealand.|X. Baraliakos, MD, Rheumazentrum Ruhrgebiet; F. Heldmann, MD, Rheumazentrum Ruhrgebiet; J. Callhoff, MD, German Rheumatism Research Center; R. Suppiah, MD, Departments of Rheumatology, and Counties Manukau District Health Boards; F.M. McQueen, MD, Department of Rheumatology, University of Auckland; D. Krause, MD, Rheumatology Practice; C. Klink, MD, Rheumatology Practice; E. Schmitz-Bortz, MD, Rheumatology Practice; M. Igelmann, MD, Rheumatology Practice; L. Kalthoff, MD, Rheumatology Practice; U. Kiltz, MD, Rheumazentrum Ruhrgebiet; A. Schmuedderich, MD, Rheumazentrum Ruhrgebiet; J. Braun, MD, Rheumazentrum Ruhrgebiet.
authors.forename: Frank
authors.initials: F
authors.lastname: Heldmann
authors.affiliation: From the Rheumazentrum Ruhrgebiet, Herne; German Rheumatism Research Center, Berlin; Rheumatology Practice, Gladbeck; Rheumatology Practice, Hattingen; Rheumatology Practice, Bochum; Rheumatology Practice, Ruhr, Germany; Departments of Rheumatology, and Counties Manukau District Health Boards; Department of Rheumatology, University of Auckland, Auckland, New Zealand.|X. Baraliakos, MD, Rheumazentrum Ruhrgebiet; F. Heldmann, MD, Rheumazentrum Ruhrgebiet; J. Callhoff, MD, German Rheumatism Research Center; R. Suppiah, MD, Departments of Rheumatology, and Counties Manukau District Health Boards; F.M. McQueen, MD, Department of Rheumatology, University of Auckland; D. Krause, MD, Rheumatology Practice; C. Klink, MD, Rheumatology Practice; E. Schmitz-Bortz, MD, Rheumatology Practice; M. Igelmann, MD, Rheumatology Practice; L. Kalthoff, MD, Rheumatology Practice; U. Kiltz, MD, Rheumazentrum Ruhrgebiet; A. Schmuedderich, MD, Rheumazentrum Ruhrgebiet; J. Braun, MD, Rheumazentrum Ruhrgebiet.
authors.forename: Johanna
authors.initials: J
authors.lastname: Callhoff
authors.affiliation: From the Rheumazentrum Ruhrgebiet, Herne; German Rheumatism Research Center, Berlin; Rheumatology Practice, Gladbeck; Rheumatology Practice, Hattingen; Rheumatology Practice, Bochum; Rheumatology Practice, Ruhr, Germany; Departments of Rheumatology, and Counties Manukau District Health Boards; Department of Rheumatology, University of Auckland, Auckland, New Zealand.|X. Baraliakos, MD, Rheumazentrum Ruhrgebiet; F. Heldmann, MD, Rheumazentrum Ruhrgebiet; J. Callhoff, MD, German Rheumatism Research Center; R. Suppiah, MD, Departments of Rheumatology, and Counties Manukau District Health Boards; F.M. McQueen, MD, Department of Rheumatology, University of Auckland; D. Krause, MD, Rheumatology Practice; C. Klink, MD, Rheumatology Practice; E. Schmitz-Bortz, MD, Rheumatology Practice; M. Igelmann, MD, Rheumatology Practice; L. Kalthoff, MD, Rheumatology Practice; U. Kiltz, MD, Rheumazentrum Ruhrgebiet; A. Schmuedderich, MD, Rheumazentrum Ruhrgebiet; J. Braun, MD, Rheumazentrum Ruhrgebiet.
authors.forename: Ravi
authors.initials: R
authors.lastname: Suppiah
authors.affiliation: From the Rheumazentrum Ruhrgebiet, Herne; German Rheumatism Research Center, Berlin; Rheumatology Practice, Gladbeck; Rheumatology Practice, Hattingen; Rheumatology Practice, Bochum; Rheumatology Practice, Ruhr, Germany; Departments of Rheumatology, and Counties Manukau District Health Boards; Department of Rheumatology, University of Auckland, Auckland, New Zealand.|X. Baraliakos, MD, Rheumazentrum Ruhrgebiet; F. Heldmann, MD, Rheumazentrum Ruhrgebiet; J. Callhoff, MD, German Rheumatism Research Center; R. Suppiah, MD, Departments of Rheumatology, and Counties Manukau District Health Boards; F.M. McQueen, MD, Department of Rheumatology, University of Auckland; D. Krause, MD, Rheumatology Practice; C. Klink, MD, Rheumatology Practice; E. Schmitz-Bortz, MD, Rheumatology Practice; M. Igelmann, MD, Rheumatology Practice; L. Kalthoff, MD, Rheumatology Practice; U. Kiltz, MD, Rheumazentrum Ruhrgebiet; A. Schmuedderich, MD, Rheumazentrum Ruhrgebiet; J. Braun, MD, Rheumazentrum Ruhrgebiet.
authors.forename: Fiona Marion
authors.initials: FM
authors.lastname: McQueen
authors.affiliation: From the Rheumazentrum Ruhrgebiet, Herne; German Rheumatism Research Center, Berlin; Rheumatology Practice, Gladbeck; Rheumatology Practice, Hattingen; Rheumatology Practice, Bochum; Rheumatology Practice, Ruhr, Germany; Departments of Rheumatology, and Counties Manukau District Health Boards; Department of Rheumatology, University of Auckland, Auckland, New Zealand.|X. Baraliakos, MD, Rheumazentrum Ruhrgebiet; F. Heldmann, MD, Rheumazentrum Ruhrgebiet; J. Callhoff, MD, German Rheumatism Research Center; R. Suppiah, MD, Departments of Rheumatology, and Counties Manukau District Health Boards; F.M. McQueen, MD, Department of Rheumatology, University of Auckland; D. Krause, MD, Rheumatology Practice; C. Klink, MD, Rheumatology Practice; E. Schmitz-Bortz, MD, Rheumatology Practice; M. Igelmann, MD, Rheumatology Practice; L. Kalthoff, MD, Rheumatology Practice; U. Kiltz, MD, Rheumazentrum Ruhrgebiet; A. Schmuedderich, MD, Rheumazentrum Ruhrgebiet; J. Braun, MD, Rheumazentrum Ruhrgebiet.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Krause
authors.affiliation: From the Rheumazentrum Ruhrgebiet, Herne; German Rheumatism Research Center, Berlin; Rheumatology Practice, Gladbeck; Rheumatology Practice, Hattingen; Rheumatology Practice, Bochum; Rheumatology Practice, Ruhr, Germany; Departments of Rheumatology, and Counties Manukau District Health Boards; Department of Rheumatology, University of Auckland, Auckland, New Zealand.|X. Baraliakos, MD, Rheumazentrum Ruhrgebiet; F. Heldmann, MD, Rheumazentrum Ruhrgebiet; J. Callhoff, MD, German Rheumatism Research Center; R. Suppiah, MD, Departments of Rheumatology, and Counties Manukau District Health Boards; F.M. McQueen, MD, Department of Rheumatology, University of Auckland; D. Krause, MD, Rheumatology Practice; C. Klink, MD, Rheumatology Practice; E. Schmitz-Bortz, MD, Rheumatology Practice; M. Igelmann, MD, Rheumatology Practice; L. Kalthoff, MD, Rheumatology Practice; U. Kiltz, MD, Rheumazentrum Ruhrgebiet; A. Schmuedderich, MD, Rheumazentrum Ruhrgebiet; J. Braun, MD, Rheumazentrum Ruhrgebiet.
authors.forename: Claudia
authors.initials: C
authors.lastname: Klink
authors.affiliation: From the Rheumazentrum Ruhrgebiet, Herne; German Rheumatism Research Center, Berlin; Rheumatology Practice, Gladbeck; Rheumatology Practice, Hattingen; Rheumatology Practice, Bochum; Rheumatology Practice, Ruhr, Germany; Departments of Rheumatology, and Counties Manukau District Health Boards; Department of Rheumatology, University of Auckland, Auckland, New Zealand.|X. Baraliakos, MD, Rheumazentrum Ruhrgebiet; F. Heldmann, MD, Rheumazentrum Ruhrgebiet; J. Callhoff, MD, German Rheumatism Research Center; R. Suppiah, MD, Departments of Rheumatology, and Counties Manukau District Health Boards; F.M. McQueen, MD, Department of Rheumatology, University of Auckland; D. Krause, MD, Rheumatology Practice; C. Klink, MD, Rheumatology Practice; E. Schmitz-Bortz, MD, Rheumatology Practice; M. Igelmann, MD, Rheumatology Practice; L. Kalthoff, MD, Rheumatology Practice; U. Kiltz, MD, Rheumazentrum Ruhrgebiet; A. Schmuedderich, MD, Rheumazentrum Ruhrgebiet; J. Braun, MD, Rheumazentrum Ruhrgebiet.
authors.forename: Elmar
authors.initials: E
authors.lastname: Schmitz-Bortz
authors.affiliation: From the Rheumazentrum Ruhrgebiet, Herne; German Rheumatism Research Center, Berlin; Rheumatology Practice, Gladbeck; Rheumatology Practice, Hattingen; Rheumatology Practice, Bochum; Rheumatology Practice, Ruhr, Germany; Departments of Rheumatology, and Counties Manukau District Health Boards; Department of Rheumatology, University of Auckland, Auckland, New Zealand.|X. Baraliakos, MD, Rheumazentrum Ruhrgebiet; F. Heldmann, MD, Rheumazentrum Ruhrgebiet; J. Callhoff, MD, German Rheumatism Research Center; R. Suppiah, MD, Departments of Rheumatology, and Counties Manukau District Health Boards; F.M. McQueen, MD, Department of Rheumatology, University of Auckland; D. Krause, MD, Rheumatology Practice; C. Klink, MD, Rheumatology Practice; E. Schmitz-Bortz, MD, Rheumatology Practice; M. Igelmann, MD, Rheumatology Practice; L. Kalthoff, MD, Rheumatology Practice; U. Kiltz, MD, Rheumazentrum Ruhrgebiet; A. Schmuedderich, MD, Rheumazentrum Ruhrgebiet; J. Braun, MD, Rheumazentrum Ruhrgebiet.
authors.forename: Manfred
authors.initials: M
authors.lastname: Igelmann
authors.affiliation: From the Rheumazentrum Ruhrgebiet, Herne; German Rheumatism Research Center, Berlin; Rheumatology Practice, Gladbeck; Rheumatology Practice, Hattingen; Rheumatology Practice, Bochum; Rheumatology Practice, Ruhr, Germany; Departments of Rheumatology, and Counties Manukau District Health Boards; Department of Rheumatology, University of Auckland, Auckland, New Zealand.|X. Baraliakos, MD, Rheumazentrum Ruhrgebiet; F. Heldmann, MD, Rheumazentrum Ruhrgebiet; J. Callhoff, MD, German Rheumatism Research Center; R. Suppiah, MD, Departments of Rheumatology, and Counties Manukau District Health Boards; F.M. McQueen, MD, Department of Rheumatology, University of Auckland; D. Krause, MD, Rheumatology Practice; C. Klink, MD, Rheumatology Practice; E. Schmitz-Bortz, MD, Rheumatology Practice; M. Igelmann, MD, Rheumatology Practice; L. Kalthoff, MD, Rheumatology Practice; U. Kiltz, MD, Rheumazentrum Ruhrgebiet; A. Schmuedderich, MD, Rheumazentrum Ruhrgebiet; J. Braun, MD, Rheumazentrum Ruhrgebiet.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Kalthoff
authors.affiliation: From the Rheumazentrum Ruhrgebiet, Herne; German Rheumatism Research Center, Berlin; Rheumatology Practice, Gladbeck; Rheumatology Practice, Hattingen; Rheumatology Practice, Bochum; Rheumatology Practice, Ruhr, Germany; Departments of Rheumatology, and Counties Manukau District Health Boards; Department of Rheumatology, University of Auckland, Auckland, New Zealand.|X. Baraliakos, MD, Rheumazentrum Ruhrgebiet; F. Heldmann, MD, Rheumazentrum Ruhrgebiet; J. Callhoff, MD, German Rheumatism Research Center; R. Suppiah, MD, Departments of Rheumatology, and Counties Manukau District Health Boards; F.M. McQueen, MD, Department of Rheumatology, University of Auckland; D. Krause, MD, Rheumatology Practice; C. Klink, MD, Rheumatology Practice; E. Schmitz-Bortz, MD, Rheumatology Practice; M. Igelmann, MD, Rheumatology Practice; L. Kalthoff, MD, Rheumatology Practice; U. Kiltz, MD, Rheumazentrum Ruhrgebiet; A. Schmuedderich, MD, Rheumazentrum Ruhrgebiet; J. Braun, MD, Rheumazentrum Ruhrgebiet.
authors.forename: Uta
authors.initials: U
authors.lastname: Kiltz
authors.affiliation: From the Rheumazentrum Ruhrgebiet, Herne; German Rheumatism Research Center, Berlin; Rheumatology Practice, Gladbeck; Rheumatology Practice, Hattingen; Rheumatology Practice, Bochum; Rheumatology Practice, Ruhr, Germany; Departments of Rheumatology, and Counties Manukau District Health Boards; Department of Rheumatology, University of Auckland, Auckland, New Zealand.|X. Baraliakos, MD, Rheumazentrum Ruhrgebiet; F. Heldmann, MD, Rheumazentrum Ruhrgebiet; J. Callhoff, MD, German Rheumatism Research Center; R. Suppiah, MD, Departments of Rheumatology, and Counties Manukau District Health Boards; F.M. McQueen, MD, Department of Rheumatology, University of Auckland; D. Krause, MD, Rheumatology Practice; C. Klink, MD, Rheumatology Practice; E. Schmitz-Bortz, MD, Rheumatology Practice; M. Igelmann, MD, Rheumatology Practice; L. Kalthoff, MD, Rheumatology Practice; U. Kiltz, MD, Rheumazentrum Ruhrgebiet; A. Schmuedderich, MD, Rheumazentrum Ruhrgebiet; J. Braun, MD, Rheumazentrum Ruhrgebiet.
authors.forename: Anna
authors.initials: A
authors.lastname: Schmuedderich
authors.affiliation: From the Rheumazentrum Ruhrgebiet, Herne; German Rheumatism Research Center, Berlin; Rheumatology Practice, Gladbeck; Rheumatology Practice, Hattingen; Rheumatology Practice, Bochum; Rheumatology Practice, Ruhr, Germany; Departments of Rheumatology, and Counties Manukau District Health Boards; Department of Rheumatology, University of Auckland, Auckland, New Zealand.|X. Baraliakos, MD, Rheumazentrum Ruhrgebiet; F. Heldmann, MD, Rheumazentrum Ruhrgebiet; J. Callhoff, MD, German Rheumatism Research Center; R. Suppiah, MD, Departments of Rheumatology, and Counties Manukau District Health Boards; F.M. McQueen, MD, Department of Rheumatology, University of Auckland; D. Krause, MD, Rheumatology Practice; C. Klink, MD, Rheumatology Practice; E. Schmitz-Bortz, MD, Rheumatology Practice; M. Igelmann, MD, Rheumatology Practice; L. Kalthoff, MD, Rheumatology Practice; U. Kiltz, MD, Rheumazentrum Ruhrgebiet; A. Schmuedderich, MD, Rheumazentrum Ruhrgebiet; J. Braun, MD, Rheumazentrum Ruhrgebiet.
authors.forename: Juergen
authors.initials: J
authors.lastname: Braun
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D001853:Bone Marrow / Q000000981:diagnostic imaging* / Q000473:pathology; D004487:Edema / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D006972:Hypertelorism / Q000000981:diagnostic imaging* / Q000473:pathology; D008607:Intellectual Disability / Q000000981:diagnostic imaging* / Q000473:pathology; D007738:Kyphosis / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D058627:Megalencephaly / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D019547:Neck Pain / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D014059:Tongue / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology
keywords: ANKYLOSING SPONDYLITIS; ATLANTOAXIAL REGION; MAGNETIC RESONANCE IMAGING; NECK PAIN; RHEUMATOID ARTHRITIS