Abstract
Background: It has been accepted amongst rheumatologists that rheumatoid arthritis (RA) does not involve the facet joints (FJs) of the spine; nevertheless, the issue is still under debate. Objective: To compare the prevalence of FJs’ changes between patients with RA and age- and sex-matched peers. Methods: CT scans of 34 patients with RA suffering from low back pain (LBP) were compared with 70 age- and sex-matched controls (individuals without RA, suffering from LBP) in a case-control study. The degenerative changes in the FJs were evaluated (i.e., joint space narrowing, marginal osteophytes, articular process hypertrophy, subchondral sclerosis, inter-joint vacuum phenomenon, and subchondral cysts), in addition to the marginal erosions, the most characteristic feature of joint change in RA. Disease activity characteristics (CRP, ESR, DAS-28, SDAI, and CDAI), duration of RA, age, and sex were obtained from patients’ clinical charts. Results: The prevalence of FJs’ changes in patients with RA and age- and sex-matched controls were not significantly different at any spinal level or in a total L1-S1 score. Marginal erosions, a characteristic feature of joint changes in RA, were not found in any of our RA subjects. No difference was found in disease parameters and markers in individuals with RA with affected FJs and those without. The occurrence of FJs’ changes amongst subjects with RA demonstrated no correlation with disease duration and activity. Conclusions: FJs of the lumbar spine are not involved in the inflammatory process of RA, and their LBP is not due to inflammation in FJs of the spine.
Highlights
It has commonly been accepted amongst rheumatologists that rheumatoid arthritis (RA) does not involve the facet joints (FJs) of the spine [1]
It has been accepted amongst rheumatologists that rheumatoid arthritis (RA) does not involve the facet joints (FJs) of the spine; the issue is still under debate
FJs of the lumbar spine are not involved in the inflammatory process of RA, and their low back pain (LBP) is not due to inflammation in FJs of the spine
Summary
It has commonly been accepted amongst rheumatologists that rheumatoid arthritis (RA) does not involve the facet joints (FJs) of the spine [1]. The FJs are synovial joints of the spine with hyaline cartilage overlying subchondral bone, a synovial membrane, and a joint capsule Due to their high level of mobility and the considerable forces influencing FJs, especially in the lumbar area, significant degenerative changes can develop and constantly be a potential source of pain and disability [2]. Objective: To compare the prevalence of FJs’ changes between patients with RA and age- and sex-matched peers. Methods: CT scans of 34 patients with RA suffering from low back pain (LBP) were compared with 70 age- and sex-matched controls (individuals without RA, suffering from LBP) in a case-control study. Results: The prevalence of FJs’ changes in patients with RA and age- and sex-matched controls were not significantly different at any spinal level or in a total L1-S1 score. Conclusions: FJs of the lumbar spine are not involved in the inflammatory process of RA, and their LBP is not due to inflammation in FJs of the spine
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