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Ann Rheum Dis. 2015 Aug;74(8):1488-94. doi: 10.1136/annrheumdis-2015-207317. Epub 2015 May 14.

From Modic 1 vertebral-endplate subchondral bone signal changes detected by MRI to the concept of 'active discopathy'.

Author information

1
University of Paris Descartes, PRES Sorbonne Paris Cité, Service de rééducation et réadaptation de l'appareil locomoteur et des pathologies du rachis, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France University of Paris Descartes, PRES Sorbonne Paris, Cité Laboratoire de Pharmacologie, Toxicologie et Signalisation Cellulaire, INSERM UMR-S 1124, UFR Biomédicale des Saints Pères, Paris, France.
2
University of Paris Descartes, PRES Sorbonne Paris Cité, Service de rééducation et réadaptation de l'appareil locomoteur et des pathologies du rachis, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France University of Paris Descartes, PRES Sorbonne Paris, INSERM UMR-S 1153 et Institut fédératif de recherche sur le handicap, Paris, France.

Abstract

Late-1980s MRI-detected vertebral-endplate subchondral bone signal changes associated with degenerative disc disease as well as recent studies suggest that in some patients, non-specific chronic low back pain (NS cLBP) can be defined by specific clinical, radiological and biological features, for a concept of active discopathy. This concept allows for associating a particular NS cLBP phenotype to a specific anatomical lesion, namely those with Modic 1 signal changes seen on MRI. Local inflammation is thought to play a pivotal role in these changes. Other etiopathogenic processes may include local infection and mechanical or biochemical stress combined with predisposing genetic factors; treatment strategies remain debated. Modic 1 changes detected by MRI can be considered a first biomarker in NS cLBP. Such changes are of high clinical relevance because they are associated with a specific clinical phenotype and can be targeted by specific treatments.

KEYWORDS:

Low Back Pain; Magnetic Resonance Imaging; Spondyloarthritis

PMID:
25977562
DOI:
10.1136/annrheumdis-2015-207317
[Indexed for MEDLINE]

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