Low back pain in rheumatoid arthritis

الملخص EN

Material : This study was conducted on forty rheumatoid arthritis (RA) patients.

They consisted of 38 females and 2 males, with a mean age of 39.55 ± 68 years.

They used to suffer from low back pain with a mean of 20.3 ± 15.5 months duration.

The mean duration of RA was 4.15 ± 3.38 years.

Five females and 15 males suffering from mechanical low back pain for a mean of 21.4 ± 13.7 months were included in the study for comparison.

Their mean age was 40.4 ± 6.7 years.

Methods : All patients were subjected to clinical and physical examination of lumbo-sacral region and imaging studies : plain X- rays both antero-posterior and lateral views as well as computed tomography (CT) of the lumbo–sacral spine.

Results : There was a significant difference in straight leg raising and femoral nerve stretch tests between the two groups.

Plain X-rays showed a highly significant difference in osteophytes and a significant difference in osteoporosis, spondylolisthesis, erosion and facet joint changes.

CT findings showed a highly significant difference at vacuum phenomenon in both groups and a significant difference in osteophytes, facet joint, disc changes and osteoporosis.

Also, there was a highly significant correlation between duration of RA and development of osteoporosis.

Type of medication and duration of RA had significant correlation with development of osteoporosis.

Conclusion : The cause of low back pain in RA is multifactorial including facet joint synovitis, crush fracture, associated osteoporosis, spondylolisthesis and disc changes.

Osteoporosis and facet joints appear more clear by using CT.