Define the prevalence and location of inflammatory and structural lesions on magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA) and radiographic axial spondyloarthritis (r-axSpA) with neck pain as leading clinical symptom. Patients with diagnosis of RA and r-axSpA were consecutively included if they had chronic (> 3 months) neck pain. Clinical assessment, neck pain questionnaires and MRIs of the cervical spine (CS) were performed. 107 patients (59 RA and 48 r-axSpA) were included. While there was no difference in the Northwick-Park-Neck-Pain-questionnaire, patients with RA reported higher neck pain compared to r-axSpA on a numeric rating scale (5.0 ± 3.6 vs. 3.0 ± 3.1; p = 0.003). Inflammatory lesions occurred predominantly in the craniocervical area in RA and in the lower CS segments in r-axSpA. Bone marrow edema (BME) was more frequent in axSpA (BME-score axSpA/RA: 0.35vs0.17; p < 0.001) while synovitis was visible in both but was more prevalent in RA (synovitis-score axSpA/RA: 0.02vs0.1; p < 0.001). BME was found in 8 (13.6%) vertebral corner vs. 9 (18.8%), in 2 (3.4%) facet joints vs. 7 (14.6%) and in 1 (1.7%) spinous processes vs. 9 (18.8%) in patients with RA/r-axSpA. In contrast, more patients with RA (30.5% vs6.3%) showed erosive osteochondrosis with endplate BME (p = 0.002). While involvement of upper cervical inflammation was typically present in RA, r-axSpA patients showed more BME in lower CS segments, vertebral corners, facet joints and spinous processes. Neck pain is linked to upper and lower inflammatory and structural lesions of the CS in both diseases.

中文翻译：

---

通过磁共振成像评估患有慢性颈痛的类风湿性关节炎和放射学中轴​​型脊柱关节炎患者炎症和结构性病变的患病率和位置


明确以颈部疼痛为主要临床症状的类风湿性关节炎 (RA) 和放射学中轴​​型脊柱关节炎 (r-axSpA) 患者的磁共振成像 (MRI) 炎症和结构性病变的患病率和位置。诊断为 RA 和 r-axSpA 的患者如果患有慢性（> 3 个月）颈部疼痛，则连续纳入。进行了临床评估、颈部疼痛调查问卷和颈椎 (CS) MRI。纳入 107 名患者（59 名 RA 和 48 名 r-axSpA）。虽然 Northwick-Park 颈部疼痛问卷没有差异，但在数字评定量表上，与 r-axSpA 相比，RA 患者报告的颈部疼痛程度更高（5.0 ± 3.6 与 3.0 ± 3.1；p = 0.003）。 RA 的炎症病变主要发生在颅颈区，r-axSpA 的炎症病变主要发生在下 CS 段。骨髓水肿 (BME) 在 axSpA 中更为常见（BME 评分 axSpA/RA：0.35vs0.17；p < 0.001），而滑膜炎在两者中均可见，但在 RA 中更为常见（滑膜炎评分 axSpA/RA：0.02vs0） .1；p < 0.001)。 BME 发现于 8 个（13.6%）椎角，9 个（18.8%），2 个（3.4%）小关节，7 个（14.6%），1 个（1.7%）棘突，9 个（18.8%） RA/r-axSpA 患者。相比之下，更多的 RA 患者（30.5% vs 6.3%）表现出伴有终板 BME 的侵蚀性骨软骨病（p = 0.002）。虽然 RA 中通常存在上颈椎炎症，但 r-axSpA 患者在下 CS 节段、椎角、小关节和棘突中表现出更多的 BME。在这两种疾病中，颈部疼痛都与颈椎的上下炎症和结构性病变有关。