Atteinte radiologique du rachis lombaire au cours de la polyarthrite rhumatoïde

Summary Aim The aim of this study was to assess the prevalence and severity of lumbar lesions on radiography of patients with rheumatoid arthritis (RA) and of population controls and to study the correlation between lumbar lesions and RA severity. Methods RA patients who met the revised American College of Rheumatology criteria were matched with population controls for age, sex, and the presence (or absence) of low back pain. Thoracolumbar radiographs were read by two observers looking for vertebral fractures, disc space narrowing, endplate erosion, facet joint involvement, and osteophytosis. A severity score was assigned to each lesion. Results This study included 60 RA patients and 60 controls, matched for sex (54 women and 6 men in each group) and age (mean age was 47.8 ± 14 years in the RA group and 48.4 ± 14 years in the control group). Prevalence of lumbar lesions was 83% in RA patients and 85% in the control subjects (p=0.8). Vertebral fractures were significantly more frequent in RA patients (p = 0.042). In the RA group, disc space narrowing and the severity of endplate erosion were both correlated with higher Larsen grades (p = 0.02 and 0.007 respectively), and the severity of endplate erosion was correlated with coxitis (p = 0.03). Discussion In our study, radiological lumbar lesions, except for vertebral fractures, were no more common among RA patients than among population controls. Endplate erosion and vertebral disc destruction were correlated with RA severity scores.