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Inflammatory changes of the lumbar spine in children and adolescents with enthesitis related arthritis; magnetic resonance imaging findings.

Vendhan, K; Sen, D; Fisher, C; Ioannou, Y; Hall-Craggs, MA; (2014) Inflammatory changes of the lumbar spine in children and adolescents with enthesitis related arthritis; magnetic resonance imaging findings. Arthritis Care Res (Hoboken) , 66 (1) pp. 40-46. 10.1002/acr.22201. Green open access

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Abstract

To describe and profile abnormalities of the lumbar spine in a cohort of patients with enthesitis related arthritis (ERA) as compared to a control group of adolescents with mechanical back pain. We performed a retrospective review of MRI lumbar spine scans of 79 patients (58 cases, 21 controls). The study was covered by IRB approval and informed consent was obtained for review of all clinical investigations. Images were reviewed by an expert MR reader who was blinded to clinical details. The presence or absence of morphological features of enthesitis, apophyseal joint synovitis and inflammation of posterior elements was assessed at each lumbar vertebral level. The apophyseal joint inflammation was graded from 0 to 3 using a grading system that was adapted from one used in adults with inflammatory facet osteoarthropathy. STATA was used for data analysis. One or more abnormalities of the lumbar spine were found in 39 (67%) of 58 cases and sacroiliitis was present in 45 (78%) cases. Apophyseal joint synovitis was seen in 22 (38%) cases and in 1 (5%) control patient. This difference was highly significant (P value = 0.004). Inflammatory changes in the interspinous ligaments were seen in a higher percentage of cases than controls and this observation was of statistical significance (P = 0.04). Statistically significant inflammation of the lumbar apophyseal joints and interspinous ligaments was seen in our cohort of ERA patients, most of whom have concurrent sacroiliitis. This could be contributing to back pain in these patients. © 2013 American College of Rheumatology.

Type: Article
Title: Inflammatory changes of the lumbar spine in children and adolescents with enthesitis related arthritis; magnetic resonance imaging findings.
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/acr.22201
Publisher version: http://dx.doi.org/10.1002/acr.22201
Additional information: © 2014 The Authors. Arthritis Care & Research is published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/1410736
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