Bone Oedema on MRI is highly associated with low bone mineral density in patients with early inflammatory back pain : results from the DESIR cohort

Un nouvel article scientifique intitulé « Bone Oedema on MRI is highly associated with low bone mineral density in patients with early inflammatory back pain : results from the DESIR cohort» a été publié dans le journal Annals of the Rheumatic Deseases.

Briot K, Durnez A, Paternotte S, Miceli-Richard C, Dougados M, Roux C.

Ann Rheum Dis. 2013 Dec;72(12):1914-9. doi: 10.1136/annrheumdis-2012-201845.

Abstract

OBJECTIVES:

To assess bone mineral density (BMD) at lumbar spine and hip in a large cohort of patients with early inflammatory back pain(IBP) suggestive of axial spondyloarthritis (SpA), and to assess systemic and bone inflammation (according to MRI) as risk factors of lowBMD.

PATIENTS AND METHODS:

332 (52.4% male) patients with IBP suggestive of axial SpA defined by Calin or Berlin criteria were recruited; they had lumbar spine and hip BMD and body composition measurements. Low BMD was defined by Z≤-2 (at least one site). Clinical, biological (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)) and imaging (x-rays, spine and sacroiliac joint MRI) parameters were compared in patientswith and without low BMD (Z≤-2). Significant parameters in univariate analysis were tested in multivariate models.

RESULTS:

Patients (mean age 33.8 years) had a short duration of axial symptoms (mean 1.6 years); 71.4% fulfilled the Assessment of Spondyloarthritis International Society criteria for axial SpA and HLA-B27 was present in 62.1%. 43 (13.0%) had low BMD (88% male). Multivariate logistic regression showed that parameters significantly associated with low BMD (any site) were the presence of bonemarrow oedema(inflammatory lesions) on MRI (OR 4.63, p=0.001), either ESR or CRP (OR 2.60, p=0.037) and male gender (OR 9.60, p=0.0004).

CONCLUSIONS:

This study conducted in a large cohort of young adults with early IBP suggestive of SpA shows that 13.0% of patients have a lowBMD and that the main risk factor associated with low BMD was inflammation on MRI.

KEYWORDS: Bone Mineral Density; Osteoporosis; Spondyloarthritis

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