Association between clinical signs assessed by manual segmental examination and findings of the lumbar facet joints on magnetic resonance scans in subjects with and without current low back pain: a prospective, single-blind study

Tina Mainka; Stefan P Lemburg; Christoph M Heyer; Jörn Altenscheidt; Volkmar Nicolas; Christoph Maier

doi:10.1016/j.pain.2013.06.018

Association between clinical signs assessed by manual segmental examination and findings of the lumbar facet joints on magnetic resonance scans in subjects with and without current low back pain

Standard

Association between clinical signs assessed by manual segmental examination and findings of the lumbar facet joints on magnetic resonance scans in subjects with and without current low back pain : a prospective, single-blind study. / Mainka, Tina; Lemburg, Stefan P; Heyer, Christoph M; Altenscheidt, Jörn; Nicolas, Volkmar; Maier, Christoph.

in: PAIN, Jahrgang 154, Nr. 9, 09.2013, S. 1886-95.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Mainka, T, Lemburg, SP, Heyer, CM, Altenscheidt, J, Nicolas, V & Maier, C 2013, 'Association between clinical signs assessed by manual segmental examination and findings of the lumbar facet joints on magnetic resonance scans in subjects with and without current low back pain: a prospective, single-blind study', PAIN, Jg. 154, Nr. 9, S. 1886-95. https://doi.org/10.1016/j.pain.2013.06.018

APA

Mainka, T., Lemburg, S. P., Heyer, C. M., Altenscheidt, J., Nicolas, V., & Maier, C. (2013). Association between clinical signs assessed by manual segmental examination and findings of the lumbar facet joints on magnetic resonance scans in subjects with and without current low back pain: a prospective, single-blind study. PAIN, 154(9), 1886-95. https://doi.org/10.1016/j.pain.2013.06.018

Vancouver

Mainka T, Lemburg SP, Heyer CM, Altenscheidt J, Nicolas V, Maier C. Association between clinical signs assessed by manual segmental examination and findings of the lumbar facet joints on magnetic resonance scans in subjects with and without current low back pain: a prospective, single-blind study. PAIN. 2013 Sep;154(9):1886-95. https://doi.org/10.1016/j.pain.2013.06.018

Bibtex

@article{b95582549631420f98f62f37587d6bff,

title = "Association between clinical signs assessed by manual segmental examination and findings of the lumbar facet joints on magnetic resonance scans in subjects with and without current low back pain: a prospective, single-blind study",

abstract = "The relevance of magnetic resonance imaging (MRI) findings such as facet joint (FJ) effusion and edema in low back pain (LBP) is still unknown. Therefore, we prospectively evaluated the presence of these MRI findings in the lumbar spine (Th12-S1) and their association with pain evoked by manual segmental FJ provocation tests (spinal percussion, springing, and segmental rotation tests) in 75 subjects with current LBP (≥30 days in the past 3 months) compared with 75 sex- and age-matched control subjects. FJs were considered painful, if ≥ 1 provocation test triggered LBP. FJs were classified as true positives, if the same FJ was painful and showed effusion and/or edema. FJs with effusion and/or edema and painful FJs were present significantly more frequently in subjects with LBP, but these conditions were also common in control subjects (27% vs 21% and 50% vs 12%, respectively). Effusion and/or edema were present in 65 subjects with LBP (87%) and in 56 control subjects (75%, not significant); painful FJs were present in 68 (91%) and 29 (39%) (P<0.01) LBP and control subjects, respectively. True-positive findings occurred in 16% of LBP FJs and in 2% of control FJs (P<0.01); 46 LBP subjects (61%) and 9 control subjects (12%, P<0.01) had true-positive findings. Pain on provocation and FJ effusion and/or edema were significantly correlated only in patients with LBP. In conclusion, only true-positive findings (ie, concurrent effusion and/or edema and positive provocation test results in the same FJ) discriminate well enough between control subjects and subjects with current LBP, whereas neither effusion and/or edema nor FJ provocations tests alone are suitable to detect suspected FJ arthropathy.",

keywords = "Aged, Female, Humans, Low Back Pain, Lumbar Vertebrae, Magnetic Resonance Imaging, Male, Middle Aged, Pain Measurement, Prospective Studies, Retrospective Studies, Single-Blind Method, Zygapophyseal Joint, Journal Article, Randomized Controlled Trial",

author = "Tina Mainka and Lemburg, {Stefan P} and Heyer, {Christoph M} and J{\"o}rn Altenscheidt and Volkmar Nicolas and Christoph Maier",

year = "2013",

month = sep,

doi = "10.1016/j.pain.2013.06.018",

language = "English",

volume = "154",

pages = "1886--95",

journal = "PAIN",

issn = "0304-3959",

publisher = "Elsevier",

number = "9",

}

RIS

TY - JOUR

T1 - Association between clinical signs assessed by manual segmental examination and findings of the lumbar facet joints on magnetic resonance scans in subjects with and without current low back pain

T2 - a prospective, single-blind study

AU - Mainka, Tina

AU - Lemburg, Stefan P

AU - Heyer, Christoph M

AU - Altenscheidt, Jörn

AU - Nicolas, Volkmar

AU - Maier, Christoph

PY - 2013/9

Y1 - 2013/9

N2 - The relevance of magnetic resonance imaging (MRI) findings such as facet joint (FJ) effusion and edema in low back pain (LBP) is still unknown. Therefore, we prospectively evaluated the presence of these MRI findings in the lumbar spine (Th12-S1) and their association with pain evoked by manual segmental FJ provocation tests (spinal percussion, springing, and segmental rotation tests) in 75 subjects with current LBP (≥30 days in the past 3 months) compared with 75 sex- and age-matched control subjects. FJs were considered painful, if ≥ 1 provocation test triggered LBP. FJs were classified as true positives, if the same FJ was painful and showed effusion and/or edema. FJs with effusion and/or edema and painful FJs were present significantly more frequently in subjects with LBP, but these conditions were also common in control subjects (27% vs 21% and 50% vs 12%, respectively). Effusion and/or edema were present in 65 subjects with LBP (87%) and in 56 control subjects (75%, not significant); painful FJs were present in 68 (91%) and 29 (39%) (P<0.01) LBP and control subjects, respectively. True-positive findings occurred in 16% of LBP FJs and in 2% of control FJs (P<0.01); 46 LBP subjects (61%) and 9 control subjects (12%, P<0.01) had true-positive findings. Pain on provocation and FJ effusion and/or edema were significantly correlated only in patients with LBP. In conclusion, only true-positive findings (ie, concurrent effusion and/or edema and positive provocation test results in the same FJ) discriminate well enough between control subjects and subjects with current LBP, whereas neither effusion and/or edema nor FJ provocations tests alone are suitable to detect suspected FJ arthropathy.

AB - The relevance of magnetic resonance imaging (MRI) findings such as facet joint (FJ) effusion and edema in low back pain (LBP) is still unknown. Therefore, we prospectively evaluated the presence of these MRI findings in the lumbar spine (Th12-S1) and their association with pain evoked by manual segmental FJ provocation tests (spinal percussion, springing, and segmental rotation tests) in 75 subjects with current LBP (≥30 days in the past 3 months) compared with 75 sex- and age-matched control subjects. FJs were considered painful, if ≥ 1 provocation test triggered LBP. FJs were classified as true positives, if the same FJ was painful and showed effusion and/or edema. FJs with effusion and/or edema and painful FJs were present significantly more frequently in subjects with LBP, but these conditions were also common in control subjects (27% vs 21% and 50% vs 12%, respectively). Effusion and/or edema were present in 65 subjects with LBP (87%) and in 56 control subjects (75%, not significant); painful FJs were present in 68 (91%) and 29 (39%) (P<0.01) LBP and control subjects, respectively. True-positive findings occurred in 16% of LBP FJs and in 2% of control FJs (P<0.01); 46 LBP subjects (61%) and 9 control subjects (12%, P<0.01) had true-positive findings. Pain on provocation and FJ effusion and/or edema were significantly correlated only in patients with LBP. In conclusion, only true-positive findings (ie, concurrent effusion and/or edema and positive provocation test results in the same FJ) discriminate well enough between control subjects and subjects with current LBP, whereas neither effusion and/or edema nor FJ provocations tests alone are suitable to detect suspected FJ arthropathy.

KW - Aged

KW - Female

KW - Humans

KW - Low Back Pain

KW - Lumbar Vertebrae

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Pain Measurement

KW - Prospective Studies

KW - Retrospective Studies

KW - Single-Blind Method

KW - Zygapophyseal Joint

KW - Journal Article

KW - Randomized Controlled Trial

U2 - 10.1016/j.pain.2013.06.018

DO - 10.1016/j.pain.2013.06.018

M3 - SCORING: Journal article

C2 - 23778295

VL - 154

SP - 1886

EP - 1895

JO - PAIN

JF - PAIN

SN - 0304-3959

IS - 9

ER -