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MR-defined fat infiltration of the lumbar paravertebral muscles differs between non-radiographic axial spondyloarthritis and established ankylosing spondylitis

  • Original Article
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Modern Rheumatology

Abstract

Objective

The aim of our study was to compare the magnetic resonance imaging (MRI)-defined cross-sectional area and semi-quantitative grading of fatty degeneration of lumbar paravertebral muscles in patients with non-radiographic axial spondyloarthritis (nr-axSpA) and established ankylosing spondylitis (AS).

Methods

Cross-sectional area (CSA) of lumbar paravertebral muscles, including the right and left multifidus (MF), erector spina (ES), psoas (PS), vertebral body and muscle:vertebra ratio (MVr), was measured. Fat infiltration of the paravertebral muscles was graded semi-quantitatively.

Results

The CSA of the MF, ES and PS muscles and the MVr (at the L2, L3, L4 and L5 levels) were quite similar between patients with nr-axSpA (n = 14) and AS (n = 22). However, patients with AS had higher grades of fat infiltration than those with nr-axSpA (Right L4 grading of MF + ES muscles: 1.4 ± 0.73 vs. 0.51 ± 0.52, respectively, p = 0.001; left L4 grading: 1.36 ± 0.65 vs. 0.38 ± 0.50, respectively, p < 0.0001). This difference remained significant after adjusting for age and symptom duration. The inter-rater reliability was good (intraclass correlation coefficient 0.75 and 0.85).

Conclusions

This is first study demonstrating that MRI-defined fatty degeneration differs between patients with nr-axSpA and established AS. Semi-quantitative grading is reliable, and fatty degeneration of paravertebral muscles seems to be related to chronicity and spinal functions in patients with nr-axSpA and AS.

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Authors and Affiliations

  1. Division of Rheumatology, Department of PMR, Faculty of Medicine, Gevher Nesibe Hospital, Erciyes University, 38039, Kayseri, Turkey

    Ozgur Akgul & Salih Ozgocmen

  2. Department of PMR, Faculty of Medicine, Firat University, Elazig, Turkey

    Arif Gulkesen & Gurkan Akgol

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  1. Ozgur Akgul
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  2. Arif Gulkesen
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  4. Salih Ozgocmen
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Correspondence to Ozgur Akgul.

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Akgul, O., Gulkesen, A., Akgol, G. et al. MR-defined fat infiltration of the lumbar paravertebral muscles differs between non-radiographic axial spondyloarthritis and established ankylosing spondylitis. Mod Rheumatol 23, 811–816 (2013). https://doi.org/10.1007/s10165-012-0750-6

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  • DOI: https://doi.org/10.1007/s10165-012-0750-6

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