Correlation of histopathological findings and magnetic resonance imaging in the spine of patients with ankylosing spondylitis

Appel, Heiner; Loddenkemper, Christoph; Grozdanovic, Zarko; Ebhardt, Harald; Dreimann, Marc; Hempfing, Axel; Stein, Harald; Metz-Stavenhagen, P.; Rudwaleit, Martín; Sieper, Joachim

doi:10.1186/ar2035

Cited by 155 publications

(33 citation statements)

References 15 publications

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“…No magnetic resonance images (MRI) were taken, so that possible initial bone marrow oedema after implanting were not detected. Nevertheless persistent oedema and histological equivalents [22][23][24][25], such as microfractures of the trabeculae, bleeding in the fatty marrow and cartilage changes would have been detected in the histology. Such findings were not observed more often in either group.…”

Section: Discussionmentioning

confidence: 99%

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

Goetzen

Hofmann‐Fliri

Arens

et al. 2017

International Orthopaedics (SICOT)

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Purpose Subchondral screw abutment in osteosynthesis of joint fractures is an effective method to achieve sufficient screw grip. In this study we investigated if subchondral screw placement is possible without harming the overlying subchondral plate and joint cartilage iatrogenic. Materials and Methods A 3.5-mm conventional steel screw was placed in the tibia of ten sheep in distances between 1 and 7 mm beneath the joint cartilage. After a follow up of two and four months, evaluation of the subchondral bone and joint cartilage was performed by means of a histological osteoarthritis score, HRpQCT imaging and determination of the glycosaminoglycan content in the cartilage. The control group was the contralateral knee of the same animal. Results Histomorphometric evaluation of the Mankin osteoarthritis score revealed no significant difference compared to the control after two (p = 0.102) and four months (p = 0.429).No correlation between distance of the screw to the cartilage and histological scoring was found (p = 0.658, R2 = 0.04 after two months and p = 0.171, R2 = 0.18 after four months). HRpQCT measurements of the subchondral thickness between screw and cartilage after two (p = 0.05) and four months (p = 0.424) showed no significant difference. Mean glycosaminoglycan content in the treatment group compared to the control after two months (p = 0.25) and four months (p = 0.523) was not significant different. Conclusion In conclusion subchondral screw abutment did not damage the joint cartilage after a two-and four-month follow up in this sheep model.

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Section: Discussionmentioning

confidence: 99%

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

Goetzen

Hofmann‐Fliri

Arens

et al. 2017

International Orthopaedics (SICOT)

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“…Articles to be excluded were (1) reviews, (2) case reports with less than ten patients, (3) comments/letters, (4) animal studies, (5) ex vivo studies, (6) in vitro studies, (7) double publications, and (8) studies that did not really investigate VESC. Furthermore, articles on specific diagnoses or conditions already defined as having an association with LBP were excluded (e.g.…”

Section: Review Processmentioning

confidence: 99%

“…In all these cases, consensus was obtained without difficulties by authors 1 and 5. A total of 60 papers were excluded after review; 27 as they dealt with specific LBP conditions ( Table 2) and 33 for other reasons: one review article [55], four case reports [7,27,129,148], one double publication [90], one of two studies reporting data from the same study sample [80], ten for evaluating signal changes other than those related to the endplate [6,20,51,53,71,113,116,139,146,150], and eight articles because they did not report the exact numbers needed to calculate the prevalence rates of VESC [4,10,109,110,114,122,133,141]. Finally, eight articles were excluded because the study samples were selected on the basis of the presence of VESC [41, 50,56,63,68,134,137,149].…”

Section: Review Processmentioning

confidence: 99%

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

Jensen

Karppinen

Sorensen³

et al. 2008

Eur Spine J

401

297

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The prevalence of ''vertebral endplate signal changes'' (VESC) and its association with low back pain (LBP) varies greatly between studies. This wide range in reported prevalence rates and associations with LBP could be explained by differences in the definitions of VESC, LBP, or study sample. The objectives of this systematic critical review were to investigate the current literature in relation to the prevalence of VESC (including Modic changes) and the association with non-specific low back pain (LBP). The MEDLINE, EMBASE, and SveMED databases were searched for the period 1984 to November 2007. Included were the articles that reported the prevalence of VESC in non-LBP, general, working, and clinical populations. Included were also articles that investigated the association between VESC and LBP. Articles on specific LBP conditions were excluded. A checklist including items related to the research questions and overall quality of the articles was used for data collection and quality assessment. The reported prevalence rates were studied in relation to mean age, gender, study sample, year of publication, country of study, and quality score. To estimate the association between VESC and LBP, 2 9 2 tables were created to calculate the exact odds ratio (OR) with 95% confidence intervals. Eighty-two study samples from 77 original articles were identified and included in the analysis. The median of the reported prevalence rates for any type of VESC was 43% in patients with non-specific LBP and/or sciatica and 6% in non-clinical populations. The prevalence was positively associated with age and was negatively associated with the overall quality of the studies. A positive association between VESC and non-specific LBP was found in seven of ten studies from the general, working, and clinical populations with ORs from 2.0 to 19.9. This systematic review shows that VESC is a common MRI-finding in patients with non-specific LBP and is associated with pain. However, it should be noted that VESC may be present in individuals without LBP.

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“…BME is also an important early feature of sacroiliitis occurring in the spondyloarthropathies. Appel and colleagues [9] described a small series of eight ankylosing spondylitis patients in whom bone biopsy was taken from the zygapophyseal joints and histological examination revealed osteitis corresponding to regions of MRI BME. BME has also been described in psoriatic arthritis [10], in which it may be associated with dactylitis [11], enthesitis, and especially arthritis mutilans [12].…”

Section: Mri Bone Edema - Common In Inflammatory Arthritismentioning

confidence: 99%

Bone marrow edema and osteitis in rheumatoid arthritis: the imaging perspective

McQueen

2012

Arthritis Res Ther

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Magnetic resonance imaging bone marrow edema is an imaging feature that has been described in many conditions, including osteomyelitis, overuse syndromes, avascular necrosis, trauma, and inflammatory arthritides. In rheumatoid arthritis (RA), bone edema has special significance as it has been shown to be a common and widespread lesion that is often apparent at the hands and wrists but has also been described elsewhere, including the feet. It may occur in early or late disease and has been shown in several large cohort studies to have major negative implications for prognosis. It is the strongest predictor of erosive progression yet to be identified and characteristically occurs in those patients with the most aggressive and potentially disabling disease. In patients with undifferentiated arthritis, bone edema also predicts progression to criteria-positive RA, both independently and to a greater extent when combined with anti-cyclic citrullinated peptide status or rheumatoid factor positivity. Its histological correlate in the late stages of RA has been shown to be osteitis, in which the bone marrow beneath the joint is invaded by an inflammatory and vascular lymphoplasmacytic infiltrate. This lies adjacent to trabecular bone, where increased numbers of osteoclasts have been observed within resorption lacunae, suggesting a mechanistic link between inflammation and erosive bone damage. This could lead to erosion both of the overlying cortex, leading to classic radiographic rheumatoid erosions, and of local trabecular bone, possibly contributing to periarticular osteopenia and cyst formation. In addition to synovitis, osteitis is now regarded as a major rheumatoid lesion that is responsive to therapeutic intervention.

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Correlation of histopathological findings and magnetic resonance imaging in the spine of patients with ankylosing spondylitis

Cited by 155 publications

References 15 publications

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

Bone marrow edema and osteitis in rheumatoid arthritis: the imaging perspective

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