Chen L, et al. - In this cross-sectional study of individuals randomly chosen from a typical community in Hangzhou Eastern China, despite back pain status (n = 478), researchers ascertained the prevalence and distribution patterns of lumbar vertebral endplate defects and their relationships with back pain in a population-based sample. In 301 persons and 842 endplates, endplate defects displayed. In multivariate analyses, the presence of endplate defects, although not MCs and disc degeneration, was related to lifetime back pain. Focal and erosive endplate defects were correlated to lifetime back pain history, whereas all three types of defects were related to the intensity of worst back pain over the past 12 months. Therefore, in adults, endplate defects are prevalent findings on lumbar MRIs. Further, particular types of endplate defects were related to back pain history. Moreover, endplate defects could be an independent risk factor for back pain.