scholarly journals AB0865 EPIDURITIS IN INFECTIOUS SPONDYLODISCITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1739.3-1739
Author(s):  
J. Mahbouba ◽  
O. Jomaa ◽  
S. Zrour ◽  
I. Bejia ◽  
M. Touzi ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Psoas Muscle ◽  
Cord Compression ◽  
Radiological Data ◽  
Co Morbidity ◽  
Radiological Control ◽  
Infectious Spondylodiscitis ◽  
Neurological Prognosis ◽  
Magnetic Resonance Imaging Mri ◽  
Inflammatory Syndrome

Background:The main problem with infectious spondylodiscitis (ISD) is the diagnosis difficulty. Tuberculosis, with deceptive clinical semiology, remains to date the most common cause in underdeveloped and developing countries.Objectives:To report the frequency and characteristics of epiduritis in ISD and to specify its short and medium-term impact through a series of 70 cases.Methods:A descriptive retrospective study was conducted including patients with ISD, hospitalized in the rheumatology department at Fattouma bourguiba Hospital,Monastir TUNISIA between January 2009 and August 2019. Socio-demographic, clinico_biological and radiological data were collected.Results:34 male and 36 female were included. The average age was 53.91 ±15.3 years. The mean time to visit was 80.3±89 days [4,520]. Co-morbidity was noted in 66.7% of patients: diabetes (22), hypertension (18), hemodialysis (8), heart disease (4), and long term corticosteroid therapy (4). Tuberculosis contagion was present in 7.2% of patients. The most frequent reason for consultation was low back pain (63.8%) with a root syndrome in most patients (>50%). Neurological abnormalities were noted in 8.7% of patients. Skin swelling was noted in 4.3% of patients. Biological inflammatory syndrome and hyperleukocytosis were the moost biological abnormalities reported respectively in 81.2% and 30.4% of patients,. Among 70 ISD: 29 were with common germ, 18 with tuberculosis, 8 with brucellosis, and 14 with an undetermined germ. 91.3% of patients underwent a spinal magnetic resonance imaging (MRI): epiduritis was documented in 72% of cases, frequently anterior (53%). The epidural abscesses association was noted in 33 patients. It was pronounced mostly at the lumbar (19) and dorsal (14) levels. Epiduritis was frequently associated with para-vertebral soft tissues infiltration: pre-vertebral thickening (32), pre-vertebral collection (17), psoas muscle abscesses, (13). Spinal cord compression was noted in 2 patients. On 3-month visit, the ISD associated with epiduritis evolution was characterized by persistence of pain, hence radiological control was justified in 6 patients. A persistent biological inflammatory syndrome was noted in 27% of cases. Furthermore, 2 deaths were observed in this group of patients.Conclusion:Epiduritis rate in ISD requires a well-codified diagnostic and therapeutic strategy that will consider carfelly the neurological prognosis involved.References:doi: 10.1155/2019/7413089.doi: 10.1515/folmed-2016-0035.Acknowledgments:Rheumatology DepartmentDisclosure of Interests:None declared

scholarly journals FRI0431 PROFILE OF INFECTIOUS SPONDYLODISCITIS ACCORDING TO THE SITE: UNIFOCAL VERSUS MULTIFOCAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 814.3-814
Author(s):  
A. Ben Tekaya ◽  
L. Ben Ammar ◽  
M. Ben Hammamia ◽  
O. Saidane ◽  
S. Bouden ◽  
...  
Keyword(s):  
Current Problem ◽  
Common Factor ◽  
Cord Compression ◽  
Posterior Arch ◽  
Significant Difference ◽  
Infectious Spondylodiscitis ◽  
Vertebral Biopsy ◽  
Inflammatory Syndrome ◽  
Different Levels ◽  
A Current

Background:Infectious spondylodiscitis is a therapeutic emergency and is a current problem. It can affect the different levels of the spine. Multifocal forms, touching several floors, however remain rare.Objectives:To compare the clinical, biological, radiological and therapeutic aspects of unifocal versus multifocal spondylodiscitis.Methods:This is a retrospective study of 113 patients admitted to our service over a period of 20 years [1998-2018]. The diagnosis of spondylodiscitis was made on the basis of clinical, biological, radiological and bacteriological data. We have divided our population into two groups: unifocal and multifocal spondylodiscitis.Results:Spondylodiscitis was more frequently unifocal (75.2%) than multifocal (24.8%). The average age of the patients was 55.8 years. There were 62 men and 51 women. There was no difference in age and sex between the two groups (p=0.5 and p=0.8, respectively).Diabetes was more frequent in the group of multifocal spondylodiscitis but with no statistically significant difference (p=0.4). No statistically significant difference between the two groups regarding the start mode (p=0.7), the schedule (p=0.3), the presence of neurological signs (p=0.7), fever (p = 0.2), impaired general condition (p=0.6) and biological inflammatory syndrome (p=0.6).Cervical and dorsal spine involvement was more common in multifocal spondylodiscitis (p = 0.02 and p = 0.01; respectively). There were 11 spondylodiscitis involving 2 floors (cervical and dorsal: 2 cases, cervical and lumbar: 3 cases, dorsal and lumbar: 6 cases) and 3 spondylodiscitis involving 3 floors.Radiologically, the presence of vertebral fracture and involvement of the posterior arch was more frequent during the multifocal form (p=0.03 and p=0.001; respectively). The frequency of para-vertebral abscesses, epiduritis and the presence of spinal cord compression were similar in the two groups (p=0.6; p=0.7 and p=0.2, respectively).Tuberculosis was more frequent during the multifocal form (p = 0.05) and brucellosis during the unifocal form (p = 0.03). Disco-vertebral biopsy was performed in 79 cases. It was more often contributory during multifocal spondylodiscitis (p = 0.03).The occurrence of immediate complications was more frequent in multifocal spondylodiscitis but with no statistically significant difference (p=0.2).Conclusion:Multifocal sppondylodiscitis is seen mainly in immunocompromised subjects. Our study found that diabetes is the most common factor in immunosuppression. Note also the predominance of involvement of the posterior elements, tuberculous origin and immediate complications.Disclosure of Interests:None declared

Magnetic Resonance Imaging in the Diagnosis of Disruption of the Posterior Tibial Tendon

Foot & Ankle ◽  
1987 ◽  
Vol 8 (3) ◽  
pp. 144-147 ◽  
Author(s):  
Ian J. Alexander ◽  
Kenneth A. Johnson ◽  
Thomas H. Berquist
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Tissues ◽  
Diagnostic Technique ◽  
Clinical Findings ◽  
The Body ◽  
Posterior Tibial Tendon ◽  
Resonance Imaging ◽  
Posterior Tibial ◽  
Magnetic Resonance Imaging Mri

Magnetic resonance imaging (MRI), a useful technique of studying soft tissues of the body, can be very effective in assessing the integrity of tendons. Usually a patient with a complete tear of the posterior tibial tendon has characteristic physical findings. In the patient presented, MRI demonstrated a complete disruption of the posterior tibial tendon, despite the absence of the commonly associated clinical findings. In view of the difficulties encountered with attempted tenography of the completely torn posterior tibial tendon, MRI provides a sensitive alternative diagnostic technique.

scholarly journals VIRTOPSY IN THE CZECH REPUBLIC

2020 ◽  
Vol 6 (2) ◽  
pp. 44-48
Author(s):  
J. Frishons ◽  
V. Novotny ◽  
P. Rejtar ◽  
P. Hejna ◽  
M. A. Kislov ◽  
...  
Keyword(s):  
Czech Republic ◽  
Soft Tissues ◽  
Road Traffic ◽  
Image Data ◽  
Ct Scanning ◽  
Resonance Imaging ◽  
The Czech Republic ◽  
Aviation Accidents ◽  
Conventional Autopsy ◽  
Magnetic Resonance Imaging Mri

Postmortem computer tomography (CT) came into practice of forensic medicine in the 1990s and has later been complemented with magnetic resonance imaging (MRI). A pioneer virtual autopsy was conducted in Germany in 1983. In the Czech Republic, this examination was first performed in 1993.A typical examination requires about 30 min, with the most resource-demanding stage being the image data rendering. CT was shown to better capture skeletal structures, while MRI contrasting is superior in terms of visualising soft tissues. In the Czech Republic, CT-based virtopsy is legislated mandatory to document deaths inflicted by gunshots, road traffic and aviation accidents, high falls, occupational and explosive-related injuries, thermal and mechanical traumas, strangulation, drowning as well as to examine unidentified or decomposing bodies, deceased children and adolescents aged under 18.CT scanning prior to conventional autopsy provides a forensic expert with guidance to reveal pathologies non-invasively in particular regions that are difficult to dissect or access. The advantage of virtopsy is the objective acquisition of data that can be re-examined, reinterpreted or juxtaposed with the results of conventional autopsy and easily recovered for possible further expertise. 

Human Birth Imaging Using MRI: Prospective cohort study (Preprint)

2021 ◽  
Author(s):  
Olivier Ami ◽  
Jean Christophe Maran ◽  
Dominique Musset ◽  
Claude Dubray ◽  
Gérard Mage ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Neurological Impairment ◽  
Invasive Technique ◽  
Resonance Imaging ◽  
Effective Utilization ◽  
Medical Risk ◽  
Non Invasive ◽  
Bony Pelvis ◽  
Magnetic Resonance Imaging Mri ◽  
Human Birth

UNSTRUCTURED Childbirth is a physiologic process with significant medical risk, as neurological impairment due to the birthing process can occur at any time. Improvements in risk assessment and anticipatory interventions are constantly needed; however, the birthing process is difficult to assess using simple imaging technology since the maternal bony pelvis and fetal skeleton interfere with visualizing the soft tissues. Magnetic resonance imaging (MRI) is a non-invasive technique with no ionizing radiation that can monitor the biomechanics of the birthing process. Effective utilization of this modality, however, requires teamwork and implementation of the appropriate safeguards to achieve appropriate safety levels. This article describes a clinically effective and safe method to perform real-time MRI during the birthing process. We report the experience of our team as part of the IMAGINAITRE research protocol (France), which aimed better understand of the biomechanics of childbirth. 

scholarly journals Numbers of Axons in Spared Neural Tissue Bridges But Not Their Widths or Areas Correlate With Functional Recovery in Spinal Cord-Injured Rats

2020 ◽  
Vol 79 (11) ◽  
pp. 1203-1217
Author(s):  
Svenja Rink ◽  
Stoyan Pavlov ◽  
Aliona Wöhler ◽  
Habib Bendella ◽  
Marilena Manthou ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Functional Recovery ◽  
Neural Tissue ◽  
Cord Compression ◽  
Cresyl Violet ◽  
Spinal Cord Tissue ◽  
Class Iii ◽  
Morphological Findings ◽  
Cord Injury ◽  
Magnetic Resonance Imaging Mri

Abstract The relationships between various parameters of tissue damage and subsequent functional recovery after spinal cord injury (SCI) are not well understood. Patients may regain micturition control and walking despite large postinjury medullar cavities. The objective of this study was to establish possible correlations between morphological findings and degree of functional recovery after spinal cord compression at vertebra Th8 in rats. Recovery of motor (Basso, Beattie, Bresnahan, foot-stepping angle, rump-height index, and ladder climbing), sensory (withdrawal latency), and bladder functions was analyzed at 1, 3, 6, 9, and 12 weeks post-SCI. Following perfusion fixation, spinal cord tissue encompassing the injury site was cut in longitudinal frontal sections. Lesion lengths, lesion volumes, and areas of perilesional neural tissue bridges were determined after staining with cresyl violet. The numbers of axons in these bridges were quantified after staining for class III β-tubulin. We found that it was not the area of the spared tissue bridges, which is routinely determined by magnetic resonance imaging (MRI), but the numbers of axons in them that correlated with functional recovery after SCI (Spearman’s ρ > 0.8; p < 0.001). We conclude that prognostic statements based only on MRI measurements should be considered with caution.

Integrity of the pectineal ligament in MRI correlates with radiographic superior pubic ramus fracture displacement

2020 ◽  
pp. 028418512091300
Author(s):  
Alexis Klengel ◽  
Hanno Steinke ◽  
Philipp Pieroh ◽  
Andreas Höch ◽  
Timm Denecke ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Pelvic Ring ◽  
Compression Fracture ◽  
Strong Positive Correlation ◽  
Lateral Compression ◽  
Pubic Ramus ◽  
Radiographic Appearance ◽  
Fracture Displacement ◽  
Superior Pubic Ramus ◽  
Magnetic Resonance Imaging Mri

Background Estimating the stability of pelvic lateral compression fractures solely by static radiographs can be difficult. In this context, the role of anterior pelvic soft tissues as potential secondary stabilizer of the pelvic ring has hardly been investigated. Purpose To correlate the initial radiographic appearance of the pubic ramus fracture with the integrity of the pectineal ligament, a strong ligament along the pecten pubis. Material and Methods In total, 31 patients with a pelvic lateral compression fracture (AO/OTA 61- B1.1/B2.1) with 33 superior pubic ramus fractures and available post-traumatic radiographs (pelvis anteroposterior, inlet, outlet) and magnetic resonance imaging (MRI) of the pelvis with fat-suppressed coronal images were reviewed retrospectively. Radiographic superior pubic ramus fracture displacement was measured and correlated to the degree of MR-morphologic alterations of the pectineal ligament (grade 0 = intact, grade 3 = rupture). Results In the majority of fractures (72.7%), associated MR-morphologic alterations of the pectineal ligament were present. Radiographic displacement and MRI grading showed a strong positive correlation (Spearman rho = 0.783, P < 0.001). The sensitivity and specificity for a radiographic displacement of >3 mm on plain radiographs to detect a structural ligament lesion on MRI (grade 2 and higher) were 73% and 100%, respectively. Conclusion Radiographic displacement of superior pubic ramus fractures >3 mm is a strong indicator for a structural lesion of the pectineal ligament. Future studies should investigate the potential biomechanical importance of this ligament for pelvic ring stability.

Metastatic tumours: spinal cord, plexus, and peripheral nerve

2017 ◽  
Author(s):  
David Schiff ◽  
Jonathan Sherman ◽  
Paul D. Brown
Keyword(s):  
Spinal Cord ◽  
Peripheral Nerve ◽  
Clinical Manifestations ◽  
Cord Compression ◽  
Management Options ◽  
Intramedullary Spinal Cord ◽  
Neurological Morbidity ◽  
Neurological Prognosis ◽  
Spinal Epidural

Systemic cancers produce substantial neurological morbidity when they spread to the spinal epidural space, producing epidural spinal cord compression—a neurological emergency. Less often, metastases spread directly to spinal cord parenchyma to manifest as intramedullary spinal cord metastasis or result in peripheral nerve dysfunction via compression of the brachial, lumbosacral, or, rarely, the cervical plexus. This chapter reviews the clinical manifestations and risk factors for development of these entities, the diagnostic approach, management options including the role of surgery, radiation (including stereotactic body radiation therapy), and chemotherapy, as well as the neurological prognosis.

scholarly journals Prevalence of Sleep-Related Disordered Breathing among Acromegaly Patients and its Correlation to Cephalometric Parameters: An Indian Perspective

2020 ◽  
Vol 56 (01) ◽  
pp. 09-14
Author(s):  
Sreejith M. ◽  
Mohd Ashraf Ganie ◽  
Ravinder Goswami ◽  
Nikhil Tandon ◽  
Randeep Guleria ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Soft Tissues ◽  
Central Sleep Apnea ◽  
Human Growth ◽  
Apnea Hypopnea Index ◽  
Sleep Related Breathing Disorders ◽  
Obstructive Sleep ◽  
Long Term Follow Up ◽  
Treatment Naïve ◽  
Magnetic Resonance Imaging Mri

Abstract Introduction Sleep-related breathing disorders (SRBDs) including obstructive sleep apnea (OSA) and central sleep apnea (CSA) are quite common and are the leading causes of mortality in acromegaly. OSA in acromegaly is generally attributed to changes in oropharyngeal soft tissues. Data on OSA in Indian acromegaly are scant, especially cephalometric findings. The aim of this study is to evaluate the burden of SRBDs in acromegaly and its correlation to cephalometric parameters. Materials and Methods A total of 32 subjects (20 men and 12 women), diagnosed with acromegaly on the basis of standard clinical, biochemical, and hormonal measurements were recruited. In addition to the above parameters, polysomnography and magnetic resonance imaging (MRI) of the pharynx were performed in all subjects. Results The mean age of the subjects was 42.66 ± 11.13 years (range = 26–66) and mean duration of study after first presentation was 7.6 ± 6.3 years (range = 0.25–32). A total of 28 of 32 (93.3%) subjects had sellar MRI documented macroadenomas while 20 (62.5%) patients were treatment naive at the time of assessment. Twenty-nine (90.6%) patients had evidence of SRBD and all of them had OSA subtype. The Apnea–Hypopnea Index (AHI) indicating severity of OSA (mild 21.8%, moderate 34.4%, and severe 34.4%) correlated positively with tongue length, uvula length, and uvula thickness on MRI. However, AHI had no correlation with the severity of GH excess or disease activity or individual parameters such as weight, body mass index, blood pressure, hemoglobin A1c, serum human growth hormone, and insulin-like growth factor-1 level. Conclusion SRBD, the generally overlooked comorbidity, is highly prevalent in subjects with acromegaly and is almost always due to OSA, the severity of which correlates positively with tongue and uvula size. Well-designed, long-term follow-up study on a large cohort of acromegalic patients is required to improve our understanding on the subject.

scholarly journals Oropharyngeal Hairy Polyp: A Case of Respiratory Failure in a Newborn

Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 465
Author(s):  
Paola Feraco ◽  
Emma Bragantini ◽  
Francesca Incandela ◽  
Cesare Gagliardo ◽  
Marina Silvestrini
Keyword(s):  
Respiratory Failure ◽  
Respiratory Distress ◽  
Surgical Planning ◽  
Soft Tissues ◽  
Neonatal Period ◽  
Upper Airway ◽  
Intracranial Extension ◽  
Essential Information ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri

Hairy polyps, also known as dermoid polyps (DPs), are rare benign cystic lesions of bigerminal origin that may occur in several head and neck regions, including the oropharynx. Despite their benign histopathological nature, DPs may be life threatening, due to their upper airway location, and DPs represent one of the most unusual causes of respiratory distress during the neonatal period. In this paper, we describe a case of respiratory failure in a newborn with an oropharyngeal mass that was accidentally found during difficult intubation. Magnetic resonance imaging (MRI) detected a well-defined soft tissue pedunculated mass, arising from the left oropharynx wall, consistent with an oropharyngeal DP. The newborn had a prompt recovery after trans-oral mass removal. Our case underlines the importance of imaging in differential diagnosis of children’s respiratory distress, secondary to a variety of lesions within the region of the skull base or oropharynx. It allowed us to assess the origin of the lesion, as well as its relationship with the adjacent soft tissues, and to exclude intracranial extension, thus providing essential information for the surgical planning.

Endometriosis of the sciatic nerve with cyclic sciatica

2014 ◽  
Vol 21 (3) ◽  
pp. 99-102 ◽  
Author(s):  
Ozdil Baskan ◽  
Ferda Ozdemir
Keyword(s):  
Magnetic Resonance Imaging ◽  
Sciatic Nerve ◽  
Soft Tissues ◽  
Uterine Cavity ◽  
Common Disease ◽  
Resonance Imaging ◽  
Irreversible Damage ◽  
Rare Manifestation ◽  
Magnetic Resonance Imaging Mri ◽  
Gynecological Disorder

Endometriosis is an important gynecological disorder which is characterized by proliferation of the functional endometrial tissue outside the uterine cavity, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis invading the sciatic nerve is a rare manifestation of a common disease. The cyclic rhythm of pain, associated with the magnetic resonance imaging (MRI) signal of the lesion should suggest a diagnosis of endometriosis. Early diagnosis and treatment are important to prevent irreversible damage to the sciatic nerve.

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