Causes of cervical-dorso-lumbar spine pain in rheumatology

Abstract

Introduction. Spinal pain is one of the most common health problems. The multiple possible diagnoses associated with this symptom make it difficult to correctly attribute back pain to a particular disease. This dilemma requires an organized approach to separate patients with mechanical disorders from those with rare systemic disorders. Aim of study. To study the clinical and paraclinical aspects of rheumatic pathologies (PSA, SA, AR, ARe, OA) regarding the pain syndrome in the cervico-dorso-lumbar spine. Methods and materials. There were retrospectively studied 1620 patients from the rheumatology and arthrology department hospitalized between 2019-2020, of which 391 were male and 1229 female patients. The average age of the subjects included in the study was 53.82 years. Results. Within SA, 57.05% of patients had diffuse pain along the spine, 30.12% had pain in the cervical region, 17.30% had pain in the thoracic region. and 86.53% had low back pain. Here the onset of the disease was mainly at 31.87 years and the first joint affected was 53.20% - the joints from lumbar region. Within PSA, the presence of pain was with a special predilection in the lumbar spine - 93.51%. The radiological stage on average was 2.15. In 91.46% of the SPA it manifested itself with cutaneous psoriasis. In the case of RA, the onset of the disease was on average at the age of 42.16 years, with diffuse pain in the spine mainly at 55.69%, at the the cervical region - 30.02%, and at the level of the lumbar joints - 61.01% with an average radiological stage of 2.57. In the case of ARe, the first affected region was the lumbar region in 21.62%, with an onset of the disease at the age of 35.51 years on average, the maximum being 62, with the presence of pain mainly in the lumbar region - 64.86% and in the cervical region in 45.94%. In OA, 70.32% had pain in the lumbar region, and 48.51% in the cervical region, with an onset of the disease on average at the age of 50.03 years, and the first joint affected in 10.98% was the lumbar region. Conclusion. The region of the spine with the most pronounced pain syndrome is lumbar - 77.77%. Paraclinical analyzes showed that the highest indices of inflammation were in RA with an average ESR of 18.04, fibrinogen 3.31, PCR 15.95, with an average morning stiffness of 69.51 min, and a radiological stage of 2.57 on average, FR of 107, and an IFA of 2.65, with lumbar pain in 61.01%.