MRI Appears to be Insensitive Predictor of Low Back Pain Origin


Spine Community News: Magnetic Resonance Imaging (MRI) revolutionized medical practice in the 20th century. This technique allowed physicians to look inside the body without the need for radiation like x-rays or computed tomography. Although MRI is a major advance in identifying abnormal anatomy, the procedure had its limitations. One of those limitations is the lack of correlation of patient complaints and abnormalities documented on scans. A recent study presented at the American College of Rheumatology (ACR) 2017 Annual meeting suggests there can be a mismatch between the presence of MRI documented anatomic abnormalities of the spine and patient complaints.

Doctors at ACR reported the results of a study designed to determine if the presence of inflammation seen on MRI in different parts of the spine could be correlated with patient’s clinical symptoms. Ninety-five patients with chronic low back pain had MRI evaluation. Of these 95 patients, 66 had signs of inflammation in the posterior components of the vertebrae. Most common was facet joint arthritis (63%), interspinous process edema (32%), and pedicle edema (10%). Patients with posterior changes were more likely to have inflammatory changes in the vertebral bodies. There was no significant association between inflammation seen on MRI and clinical data including pain characteristics.

The study authors concluded that MRI scans do not accurately predict whether an individual will experience pain. However, in patients who have low back pain, changes in the spine seen on MR could be a cause of their symptoms.

David Borenstein, MD
Executive Editor

Reference: Braun H et al. Relationship between inflammatory Anterior or Posterior Arch MRI Abnormalities and Clinical Data in Low Back Pain Patients [abstract] Arthritis Rheumatol 2017;69(suppl10)


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