A CLINICAL AND RADIOLOGICAL STUDY OF BACK PAIN IN RHEUMATOID ARTHRITIS

Five hundred and three patients with RA were questioned aboutthe symptom of back pain. Chronic back pain, lasting more than3 months, occurred in 33 per cent of the group. A group of 100back pain patients were studied in more detail using a structuredquestionnaire, clinical examination and radiology. Ninety-fourof these patients had low back pain. Particular clinical patterns(such as that of the facet syndrome) were sought but no clearcharacteristics were found. Fifty-two lumbar spine X-rays wereavailable from the RA population and these were compared to52 age and sex matched X-rays from outpatients with chronicmechanical low back pain. Significant differences between thesegroups radiologically were a higher frequency of osteoporosisand a higher frequency of disc narrowing without associatedosteophytes in the RA population. This study differs from previousreports which found other characteristic radiological featuresof RA of the lumbar spine (spondylolisthesis, facet erosions,and vertebral fracture), a discrepancy possibly resulting fromthe use of a control group having low back pain. KEY WORDS: Low back pain, Rheumatoid arthritis, Osteoporosis, Facet syndrome