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Table 3 Magnetic resonance imaging lesions (A: Cervical, B: Thoracic, C: Lumbar)

From: Significant overlap of inflammatory and degenerative features on imaging among patients with degenerative disc disease, diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis: a real-life cohort study

 

Degenerative disc disease

DISH

Axial spondyloarthritis

All

p-value

A: Cervical MRI lesions

Number of patients evaluated

12

11

4

27

 

Number of disc units evaluated

64

47

15

126

 

Number of quadrants evaluated

256

188

60

504

 

Bone marrow oedema (BMO)

Number of quadrants with BMO changes / All quadrants

10 (3.9)

5 (2.7)

3 (5.0)

18 (3.6)

0.940

Number of patients with BMO / All patients (%)

4 (33.3)

2 (18.2)

1 (25.0)

7 (25.9)

0.836

Quadrants with bone marrow oedema per patient

2.5

2.5

3

2.6

 

Erosions

Number of quadrants with erosions / All quadrants

4 (1.6)

4 (2.1)

0 (0)

8 (1.6)

0.587

Number of patients with erosions / All patients (%)

4 (33.3)

2 (18.2)

0 (0)

6 (22.2)

0.567

Quadrants with erosions per patient

1

2

 

1.3

 

Sclerosis

Number of quadrants with sclerosis / All quadrants

0 (0)

2 (1.1)

0 (0)

2 (0.4)

0.391

Number of patients with sclerosis / All patients (%)

0

2 (18.2)

0 (0)

2 (7.4)

0.444

Quadrants with sclerosis per patient

0

1

 

1

 

Fat metaplasia

Number of quadrants with fat / All quadrants

14 (5.5)

13 (6.9)

4 (6.7)

31 (6.1)

0.988

Number of patients with fat / All patients (%)

6 (50.0)

4 (36.4)

1 (25.0)

11 (40.71)

0.662

Quadrants with fat metaplasia per patient

2.3

3.2

4

2.8

 

Modic changes

Number of discovertebral units with Modic changes / All disc units

4 (6.25)

5 (10.7)

2 (13.3)

11 (8.7)

0.799

Number of patients with Modic changes / All patients (%)

2 (16.7)

4 (33.3)

2 (50)

8 (29.6)

0.232

Discovertebral units with Modic changes per patient

2

1.2

1

1.4

 

Pfirrmann changes

Number of discovertebral units with Pfirrmann changes / All disc units

64 (100)

46 (97.9)

15 (100)

125 (99.2)

0.107

Number of patients with Pfirrmann changes / All patients (%)

12 (100)

11 (100)

4 (100)

27 (100)

-

Discovertebral units with Pfirrmann changes per patient

5.3

4.2

3.7

4.6

 

Disc protrusion

Number of discovertebral units with disc protrusion / All disc units

19 (29.7)

21 (44.7)

6 (40.0)

46 (36.5)

0.923

Number of patients with disc protrusion / All patients (%)

8 (66.7)

8 (72.7)

2 (50)

18 (66.7)

1.000

Discovertebral units with disc protrusion per patient

2.4

2.6

3

2.5

 

B: Thoracic MRI lesions

Number of patients evaluated

54

27

21

102

 

Number of disc units evaluated

241

177

89

507

 

Number of quadrants evaluated

966

678

356

2000

 

Bone marrow oedema (BMO)

Number of quadrants with BMO changes / All quadrants

22 (2.3)

29 (4.3)

4 (1.1)

55 (2.7)

0.077

Number of patients with BMO / All patients (%)

12 (22.2)

10 (37.0)*3

1 (4.8)

23 (22.5)

0.024

Quadrants with bone marrow oedema per patient

1.8

2.9

4

2.4

 

Erosions

Number of quadrants with erosions / All quadrants

7 (0.7)

2 (0.3)

2 (0.6)

11 (0.5)

0.599

Number of patients with erosions / All patients (%)

4 (7.4)

2 (7.4)

2 (9.5)

8 (7.8)

0.502

Quadrants with erosions per patient

1.7

1

1

1.4

 

Sclerosis

Number of quadrants with sclerosis / All quadrants

0 (0)

0 (0)

0 (0)

0 (0)

-

Number of patients with sclerosis / All patients (%)

0 (0)

0 (0)

0 (0)

0 (0)

-

Quadrants with sclerosis per patient

     

Fat metaplasia

Number of quadrants with fat / All quadrants

25 (2.6)

56 (8.3)

21 (5.9)

102 (5.1)

< 0.001

Number of patients with fat / All patients (%)

14 (25.9)

15 (55.6)*1

11 (52.4)#1

40 (39.2)

0.014

Quadrants with fat metaplasia per patient

1.7

3.7

1.9

2.5

 

Modic changes

Number of discovertebral units with Modic changes / All disc units

5 (2.1)

8 (4.5)

1 (1.1)

14 (2.8)

0.134

Number of patients with Modic changes / All patients (%)

3 (5.6)

5 (18.5)

1 (4.8)

9 (8.8)

0.161

Discovertebral units with Modic changes per patient

1.7

1.6

1

1.6

 

Pfirrmann changes

Number of discovertebral units with Pfirrmann changes / All disc units

235 (97.5)

160 (90.4)

83 (93.2)

478 (94.3)

0.081

Number of patients with Pfirrmann changes / All patients (%)

54 (100)

27 (100)

21 (100)

102 (100)

-

Discovertebral units with Pfirrmann changes per patient

4.3

5.9

3.9

4.7

 

Disc Protrusion

Number of discovertebral units with disc protrusion / All disc units

31 (12.9)

19 (10.7)

5 (5.6)

55 (11.0)

0.333

Number of patients with disc protrusion / All patients (%)

21 (38.9)

7 (25.9)

4 (19.0)

32 (31.4)

0.221

Discovertebral units with disc protrusion per patient

1.5

2.7

1.2

1.7

 

C: Lumbar MRI lesions

Number of patients evaluated

52

24

19

95

 

Number of disc units evaluated

250

117

95

462

 

Number of quadrants evaluated

966

678

356

2000

 

Bone marrow oedema (BMO)

Number of quadrants with BMO changes / All quadrants

34 (3.5)

16 (2.4)

13 (3.6)

63 (3.1)

0.877

Number of patients with BMO / All patients (%)

18 (34.6)

10 (41.7)

8 (42.1)

36 (37.9)

0.769

Quadrants with bone marrow oedema per patient

1.9

1.6

1.6

1.7

 

Erosions

Number of quadrants with erosions / All quadrants

9 (0.9)

5 (0.7)

4 (1.1)

18 (0.9)

0.944

Number of patients with erosions / All patients (%)

8 (15.4)

2 (8.3)

4 (21.1)

14 (14.7)

0.502

Quadrants with erosions per patient

1.1

2.5

1

1.3

 

Sclerosis

Number of quadrants with sclerosis / All quadrants

1 (0.1)

1 (0.1)

3 (0.8)

5 (0.2)

0.574

Number of patients with sclerosis / All patients (%)

1 (1.9)

1 (4.2)

1 (5.3)

3 (3.2)

1.000

Quadrants with sclerosis per patient

1

1

3

1.7

 

Fat metaplasia

Number of quadrants with fat / All quadrants

93 (9.6)

27 (3.9)

43 (12,1)

163 (8.2)

0.192

Number of patients with fat / All patients (%)

34 (65.4)@2

7 (29.2)

14 (73.7)#2

55 (57.9)

0.004

Quadrants with fat metaplasia per patient

2.7

3.8

3.1

3.0

 

Modic changes

Number of discovertebral units with Modic changes / All disc units

42 (16.8)

9 (7.7)

5 (5.3)

56 (12.1)

0.069

Number of patients with Modic changes / All patients (%)

22 (42.3)

7 (29.2)

3 (15.8)

32 (33.7)

0.097

Discovertebral units with Modic changes per patient

1.9

1.3

1.7

1.7

 

Pfirrmann changes

Number of discovertebral units with Pfirrmann changes / All disc units

250 (100)

102 (87.2)

93 (97.9)

445 (96.3)

0.021

Number of patients with Pfirrmann changes / All patients (%)

52 (100)@2

21 (87.5)

19 (100)

92 (96.8)

0.022

Discovertebral units with Pfirrmann changes per patient

4.8

4.8

4.9

4.8

 

Disc protrusion

Number of discovertebral units with disc protrusion / All disc units

193 (77.2)

76 (64.9)

52 (54.7)

321 (69.5)

0.031

Number of patients with disc protrusion / All patients (%)

50 (96.2)

20 (83.3)

17 (89.5)

87 (91.6)

0.102

Discovertebral units with disc protrusion per patient

3.8

3.8

3.1

3.7

 
  1. DISH: Diffuse Idiopathic Skeletal Hyperostosis
  2. Modic changes were defined as type I, II, or III
  3. Pfirrmann changes were defined as grade II, III, IV, and V
  4. Disc protrusion was defined as grade I or II
  5. The p-value is related to the simultaneous comparison between the three groups
  6. Italic number indicates significant two by two-by-two differences:
  7. #1 Significantly higher in axial Spondyloarthritis versus Degenerative Disc Disease
  8. *1 Significantly higher in DISH versus Degenerative Disc Disease
  9. *3 Significantly higher in DISH versus axial Spondyloarthritis
  10. @2 Significantly higher in Degenerative Disc Disease versus DISH
  11. #2 Significantly higher in axial Spondyloarthritis versus DISH
  12. Percentages are presented in columns
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Arthritis Research & Therapy

ISSN: 1478-6362

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