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From Modic 1 vertebral-endplate subchondral bone signal changes detected by MRI to the concept of ‘active discopathy’
  1. Christelle Nguyen1,2,
  2. Serge Poiraudeau1,3,
  3. François Rannou1,2
  1. 1University of Paris Descartes, PRES Sorbonne Paris Cité, Service de rééducation et réadaptation de l'appareil locomoteur et des pathologies du rachis, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, Paris, France
  2. 2University of Paris Descartes, PRES Sorbonne Paris, Cité Laboratoire de Pharmacologie, Toxicologie et Signalisation Cellulaire, INSERM UMR-S 1124, UFR Biomédicale des Saints Pères, Paris, France
  3. 3University of Paris Descartes, PRES Sorbonne Paris, INSERM UMR-S 1153 et Institut fédératif de recherche sur le handicap, Paris, France
  1. Correspondence to Professor François Rannou, Rehabilitation Department, Cochin Hospital, 27, Rue du Faubourg Saint-Jacques, Paris 75014, France; francois.rannou{at}cch.aphp.fr

Abstract

Late-1980s MRI-detected vertebral-endplate subchondral bone signal changes associated with degenerative disc disease as well as recent studies suggest that in some patients, non-specific chronic low back pain (NS cLBP) can be defined by specific clinical, radiological and biological features, for a concept of active discopathy. This concept allows for associating a particular NS cLBP phenotype to a specific anatomical lesion, namely those with Modic 1 signal changes seen on MRI. Local inflammation is thought to play a pivotal role in these changes. Other etiopathogenic processes may include local infection and mechanical or biochemical stress combined with predisposing genetic factors; treatment strategies remain debated. Modic 1 changes detected by MRI can be considered a first biomarker in NS cLBP. Such changes are of high clinical relevance because they are associated with a specific clinical phenotype and can be targeted by specific treatments.

  • Low Back Pain
  • Magnetic Resonance Imaging
  • Spondyloarthritis

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