Early diagnosis of spondyloarthritis and gonarthritis with the magnetic resonance imaging

Abstract

Introduction. Musculoskeletal pain (MSP) — has now assumed the character of a non-infectious epidemic and ranks second among the causes of disability, leading to a significant loss of productivity among the working-age population in all industrialized countries. Spondyloarthrosis of the lumbar region and gonarthrosis are the main diseases that doctors face at outpatient appointments. The pathogenesis of the disease develops according to one scenario, accompanied by aseptic inflammation, involvement of the muscular and ligamentous apparatus in the process, leading to the formation of dissimilar locomotor disorders, antinociceptive insufficiency, peripheral and central sensitization. Presents the results of magnetic resonance imaging (MRI), which can be used for early diagnosis of MSD, as well as dynamic control during treatment. Aim — to assess of neuroimaging signs in patients with spondyloarthrosis and gonarthrosis, depending on the genesis of the disease. Methods. An analytical single-stage study was performed with 123 patients with an established clinical diagnosis of MSP, who were divided into four groups: primary gonarthrosis (36 people), post-traumatic (38 people), spondylogenic (30 people) and x-ray negative (19 people). To study neuroimaging signs, MRI was performed on the devices «OPENMARK 4000» 0.42 T of the company «ANKE», «OPART» 0.35 T of the company «TOSHIBA» and «Superstar» 0.35 T of the company «Neusoft medikal systems» in transversal, sagittal and coronary projections, in T1W, T2W and STIR modes with adipose tissue suppression. Results. During MRI examination, 47.2 % of patients revealed spondyloarthrosis of the III grade, 30,1 % — II grade. 33,3 % had damage in the form of fragmentation of the internal and external meniscus of the knee joint, 30.1 % of cases revealed damage to the internal meniscus in the form of longitudinal splitting and the same number of osteophytes. The most common cases were intervertebral disc sequestration (2,4 %) and expansion of the articular gap of the knee joint (4,1 %), and spondyloarthritis of the I grade (7,3 %). When compared in groups, more pronounced neuroimaging signs were detected in posttraumatic and primary gonarthrosis, and they were significantly lower in spondylogenic genesis. When examining the spine, no differences were found in the groups. Conclusion. The study showed high information content of MRI in CA and GA, which allows for early diagnosis of the disease and differential diagnosis.