Differential diagnostics of musculoskeletal pain in spondyloarthrosis and osteoarthrosis using magnetic resonance imagraphy

Abstract

Background: Musculoskeletal pain (MSP) has now become a non-infectious epidemic and is the second leading cause of disability, resulting in a significant loss of productivity among the able-bodied population in all industrialized countries. The main conditions most commonly encountered in outpatient appointments are spondyloarthritis (SA) of the lumbar spine and osteoarthritis (OA) of the knee. These diseases have similar pathogenesis and are accompanied by aseptic inflammation, involvement of muscules and ligaments, leading to the formation of various movement disorders, antinociceptive insufficiency, and peripheral and central sensitization. In this study, the results of magnetic resonance imaging (MRI) are presented, which can be used in early diagnosis of MSP, as well as dynamic control of treatment. AIM: To evaluate neuroimaging signs in patients with SA and OA depending on the cause of the disease. MATERIALS AND METHODS: Analytical one-stage study was performed with 158 patients with established clinical diagnosis of MSB, who were divided into four groups: primary knee OA (46 patients), posttraumatic OA (48 patients), spondylogenic OA (40 patients) and OA of 0–I stage (24 patients) To study neuroimaging signs the examination was performed on MRI devices Siemens Magnetom Aera 1.5T and General Electric Signa 1.5T. RESULTS: MRI examination revealed stage III spondyloarthritis in 47.2% of patients, and stage II in 30.1%. Of the total number of patients, 33.3% had fragmentation of the inner and outer menisci of the knee joint, longitudinal damage of the inner meniscus was detected in 30.1% of cases and osteophytes of the knee joint in 30% of cases. Intervertebral disc sequestration (2.4%) and stage I spondyloarthrosis (7.3%) were the least common. When comparing the groups, more pronounced neuroimaging signs were detected in posttraumatic and primary OA, while they were significantly lower in spondylogenic genesis. No differences between the groups were found in the spine examination. CONCLUSION: The study showed high informativeness of MRI in OA, which allows early diagnosis and differential diagnosis of the disease.