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Published online before print February 19, 2003, 10.1148/radiol.2271011821
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(Radiology 2003;227:143-148.)
© RSNA, 2003

Musculoskeletal Imaging

Radiologic Phenotypes in Lumbar MR Imaging for a Gene Defect in the COL9A3 Gene of Type IX Collagen1

Jaro Karppinen, MD, Eija Pääkkö, MD, PhD, Petteri Paassilta, MD, PhD, Jaana Lohiniva, MC, Mauno Kurunlahti, MD, Osmo Tervonen, MD, PhD, Pentti Nieminen, PhD, Harald H. H. Göring, PhD, Antti Malmivaara, MD, PhD, Heikki Vanharanta, MD, PhD and Leena Ala-Kokko, MD, PhD

1 From the Depts of Physical Medicine and Rehabilitation (J.K., H.V.) and Radiology (E.P., M.K., O.T.), Univ Hosp of Oulu, PL 25, FIN-90029 Oulu, Finland; Collagen Research Unit, Biocenter and Medical Biochemistry (P.P., J.L., L.A.K.) and Medical Informatics Group (P.N.), Univ of Oulu, Finland; Dept of Genetics, Southwest Foundation of Biomedical Research, San Antonio, Tex (H.H.H.G.); Dept of Occupational Medicine, Finnish Inst of Occupational Health, Helsinki (J.K., A.M.); Orton Hosp, Helsinki, Finland (J.K., A.M.); and Ctr for Gene Therapy and Dept of Medicine, Tulane Univ Health Sci Ctr, New Orleans, La (L.A.K.). Received Nov 13, 2001; revision requested Jan 23, 2002; final revision received Jul 15; accepted Aug 1. J.K. supported by Finnish Office for Health Technology Assessment and Finnish Work Environment Fund and by grants from the Yrjö Jahnsson Foundaton and the Finnish National Research and Development Ctr for Welfare and Health. L.A.K. supported by Acad of Finland, NIH (AR45982), Louisiana Gene Therapy Research Consortium (New Orleans), and HCA-The Health Care Company (Nashville, Tenn). Address correspondence to J.K. (e-mail: jaro.karppinen@ttl.fi).

PURPOSE: To evaluate whether the COL9A3 tryptophan allele (Trp3 allele) is associated with a specific radiologic phenotype among patients with sciatica.

MATERIALS AND METHODS: One hundred fifty-three patients with sciatica were evaluated for the presence of Trp3 allele, Scheuermann disease, intervertebral disk degeneration, Schmorl nodules, dorsal anular tears, hyperintense lesions, and endplate degeneration on sagittal T2-weighted lumbar magnetic resonance images. The Trp3 genotype was determined by means of sequencing the COL9A3 gene. Radiologic phenotypes were evaluated while blinded to the genotype. Scheuermann disease was diagnosed if either endplate irregularities or Schmorl nodules and two of the other three criteria (disk space narrowing, disk dehydration, and wedging of anterior vertebral body margins) were present at three or more adjacent disk levels from T10–11 to L3–4. Disk degeneration was evaluated separately for each disk (T11–12 to L5–S1) and for all disks combined. Frequencies of radiologic phenotypes between individuals with or without Trp3 allele were compared.

RESULTS: Thirty-four patients had at least one Trp3 allele. When compared with the matched control subjects, they had an increased likelihood of Scheuermann disease (P = .035) and an increased number of degenerated disks from T11 to S1 (P = .021). Comparisons at individual disks showed a statistically significant increase in disk degeneration at T11–12 (analysis of all grades of degeneration [graded], P = .018; analysis of any degeneration vs none [dichotomous], P = .039) and L4–5 (graded, P = .011; dichotomous, P = .016). Prevalences of anular tears, endplate degeneration, Schmorl nodules, and hyperintense lesions were comparable.

CONCLUSION: The results of this study indicate that the presence of Trp3 allele is associated with Scheuermann disease and intervertebral disk degeneration. No associations were found for other radiologic phenotypes.

© RSNA, 2003

Index terms: Genes and genetics • Spine, diseases, 311.4963, 326.4963 • Spine, intervertebral disks, 326.4961, 326.4963, 336.4961, 336.4963 • Spine, MR, 326.12143, 336.12143






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