Prevalence and clinical significance of lumbosacral transitional vertebra LSTV in a young back pain population with suspected axial spondyloarthritis: results of the SPondyloArthritis Caught Early SPACE cohortReport as inadecuate




Prevalence and clinical significance of lumbosacral transitional vertebra LSTV in a young back pain population with suspected axial spondyloarthritis: results of the SPondyloArthritis Caught Early SPACE cohort - Download this document for free, or read online. Document in PDF available to download.

Skeletal Radiology

, Volume 46, Issue 5, pp 633–639

First Online: 24 February 2017Received: 02 December 2015Accepted: 17 January 2017DOI: 10.1007-s00256-017-2581-1

Cite this article as: de Bruin, F., ter Horst, S., Bloem, J.L. et al. Skeletal Radiol 2017 46: 633. doi:10.1007-s00256-017-2581-1

Abstract

ObjectiveTo determine in a cohort of young patients with suspected axial spondyloarthritis axSpA, the prevalence of lumbosacral transitional vertebra LSTV, its association with local bone marrow edema BME and lumbar spine degeneration, and the potential relationship with MRI findings and clinical signs of axSpA.

Materials and methodsBaseline imaging studies and clinical information of patients from the SPondyloArthritis Caught Early-cohort back pain ≥3 months, ≤2 years, onset <45 years were used. Two independent readers assessed all patients for LSTV on radiography, and BME-like and degenerative changes on MRI. Patients with and without LSTV were compared with regard to the prevalence of MRI findings and the results of clinical assessment using Chi-squared test or t test.

ResultsOf 273 patients 35.1% male, mean age 30.0, 68 25% patients showed an LSTV, without statistical significant difference between patients with and without axSpA p = 0.327. Local sacral BME was present in 9 out of 68 13% patients with LSTV and absent in patients without LSTV p < 0.001. Visual analogue scale VAS pain score and spinal mobility assessments were comparable.

ConclusionsLSTV is of low clinical relevance in the early diagnosis of axSpA. There is no difference between patients with and without LSTV regarding the prevalence of axSpA, pain and spinal mobility, and a BME-like pattern at the pseudoarticulation does not reach the SI joints.

KeywordsAxial spondyloarthritis Lumbosacral transitional vertebra Disc degeneration 



Author: F. de Bruin - S. ter Horst - J. L. Bloem - R. van den Berg - M. de Hooge - F. van Gaalen - H. Dagfinrud - M. van Oo

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