scholarly journals Radiologic Mimics of Osteomyelitis and Septic Arthritis: A Pictorial Essay

2021 ◽  
Vol 2021 ◽  
pp. 1-18
Author(s):  
Wanyin Lim ◽  
Christen D. Barras ◽  
Steven Zadow
Keyword(s):  
Septic Arthritis ◽  
Imaging Techniques ◽  
Routine Practice ◽  
Imaging Features ◽  
Cross Sectional ◽  
Musculoskeletal Infection ◽  
Neoplastic Processes ◽  
Joint Infections ◽  
Bone And Joint Infections ◽  
Pictorial Review

Various imaging techniques may be employed in the investigation of suspected bone and joint infections. These include ultrasound, radiography, functional imaging such as positron emission tomography (PET) and nuclear scintigraphy, and cross-sectional imaging, including computed tomography (CT) and magnetic resonance imaging (MRI). The cross-sectional modalities represent the imaging workhorse in routine practice. The role of imaging also extends to include assessment of the anatomical extent of infection, potentially associated complications, and treatment response. The imaging appearances of bone and joint infections are heterogeneous and depend on the duration of infection, an individual patient’s immune status, and virulence of culprit organisms. To add to the complexity of radiodiagnosis, one of the pitfalls of imaging musculoskeletal infection is the presence of other conditions that can share overlapping imaging features. This includes osteoarthritis, vasculopathy, inflammatory, and even neoplastic processes. Different pathologies may also coexist, for example, diabetic neuropathy and osteomyelitis. This pictorial review aims to highlight potential mimics of osteomyelitis and septic arthritis that are regularly encountered, with emphasis on specific imaging features that may aid the radiologist and clinician in distinguishing an infective from a noninfective aetiology.

scholarly journals Bone and Joint Infections among Hematopoietic Stem Cell Transplant Recipients

2019 ◽  
Vol 4 (5) ◽  
pp. 209-215
Author(s):  
Cybele Lara Abad ◽  
Vania Phuoc ◽  
Prashant Kapoor ◽  
Pritish K. Tosh ◽  
Irene G. Sia ◽  
...  
Keyword(s):  
Stem Cell ◽  
Septic Arthritis ◽  
Hematopoietic Stem Cell ◽  
Joint Infection ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Joint Infections ◽  
Bone And Joint Infections ◽  
Prosthetic Joint ◽  
Increased Risk

Abstract. Background: Hematopoietic stem cell transplantation (HSCT) recipients are at increased risk for infection. This study describes bone and joint infections (BJI) among HSCT recipients.Methods: We reviewed 5861 patients who underwent HSCT at Mayo Clinic, Rochester, MN from January 1, 2005 through January 1, 2015 for study inclusion. BJI was defined as native septic arthritis, prosthetic joint infection, osteomyelitis, and orthopedic implant infection. All adults with BJI after HSCT were included in the analysis.Results: Of 5861 patients, 33 (0.6%) developed BJI. Native joint septic arthritis was the most common BJI occurring in 15/33 (45.4%) patients. Patients were predominantly male (24/33, 72.7%), with median age of 58 (range 20-72) years. BJI was diagnosed a median of 39 (range 1-114) months after allogeneic (14/33, 42.4%) or autologous (19/33, 57.6%) HSCT. Organisms were recovered via tissue (24/27, 88.9%), synovial fluid (13/17, 76.5%), and/or blood cultures (16/25, 64%). Most underwent surgical debridement (23/33, 69.7%). Patients were followed a median of 78.3 months (range 74-119). Therapy was unsuccessful in 4/33 (12.1%), with death related to the underlying BJI in two (50%). Failure occurred a median of 3.4 (0.1-48.5) months from diagnosis. At last follow up, 7/33 (21.2%) patients were alive. Median overall survival was 13 months (0.07-70.6).Conclusion: BJI among HSCT recipients is infrequent. The most common infection is native joint septic arthritis. Pathogens appear similar to patients without HSCT. Treatment involving surgical-medical modalities is successful, with most patients surviving >1 year after BJI.

Bone and Joint Infections

2019 ◽  
Author(s):  
Jayshree Dave ◽  
Rohma Ghani
Keyword(s):  
Septic Arthritis ◽  
Group A Streptococcus ◽  
Clinical History ◽  
Liver Function Tests ◽  
Joint Disease ◽  
Joint Fluid ◽  
Response To Treatment ◽  
Range Of Movement ◽  
Joint Infections ◽  
Bone And Joint Infections

Patients with bone and joint infections can present with native joint septic arthritis, osteomyelitis, or implant-associated bone and joint infections. Patients often present with an acute onset of hot, swollen, painful joint with restricted function in one or more joints over a couple of weeks. On examination the affected joint is painful with a limited range of movement, and fever is present. Risk factors for septic arthritis include an abnormal joint architecture due to pre-existing joint disease, e.g. patients with rheumatoid arthritis, or patients on haemodialysis, with diabetes mellitus, or older than 80 years of age. The differential diagnosis includes reactive arthritis, pre-patellar bursitis, gout, Lyme disease, brucellosis, and Whipples disease. Staphylococcus aureus is the most common cause of septic arthritis, followed by Group A streptococcus and other haemolytic streptococci including B, C and G. Gram-negative rods such as Escherichia coli are implicated in the elderly, immunosuppressed, or patients with comorbidities. Pseudomonas aeruginosa is implicated in intravenous (IV) drug users and patients post-surgery or intra-articular injections. Kingella kingae causes septic arthritis in children younger than four years of age. Neisseria gonorrhoeae, Neisseria meningitidis, and Salmonella species can also cause septic arthritis as part of a disseminated infection. Septic monoarthritis commonly occurs in patients with disseminated gonococcal infection. Blood cultures, white blood cell count, C reactive protein (CRP), electrolytes, and liver function tests are indicated. Serial CRP is useful in monitoring response to treatment. If there is a history of unprotected sexual intercourse, gonococcal testing is recommended. Brucella serology and Tropheryma whippei serology may be considered based on the clinical history. Joint fluid aspiration should be performed by a specialist within the hospital. Joint fluid aspirate is processed in the laboratory for microscopy, culture, and sensitivity. Gram stain can show an increase in neutrophils and presence of bacteria. The guidelines provided by the British Society for Rheumatology on the management of hot swollen joints in adults has provided advice for empirical treatment for suspected septic arthritis, but the local antibiotic policy should also be considered. Initial treatment is with intravenous flucloxacillin 2g four times daily, or 450– 600mg four times daily of intravenous clindamycin to cover S. aureus.

scholarly journals Developmental anomalies of the superior vena cava and its tributaries: What the radiologist needs to know?

2020 ◽  
pp. 20200856
Author(s):  
Mansi Verma ◽  
Niraj Nirmal Pandey ◽  
Vineeta Ojha ◽  
Sanjeev Kumar ◽  
Sivasubramaniam Ramakrishnan
Keyword(s):  
Superior Vena Cava ◽  
Imaging Techniques ◽  
Superior Vena ◽  
Vena Cava ◽  
Clinical Importance ◽  
Cross Sectional ◽  
Developmental Anomalies ◽  
Ct Venography ◽  
Pictorial Review ◽  
Cross Sectional Imaging

Deviations from the normal process of embryogenesis can result in various developmental anomalies of the superior vena cava (SVC). While these anomalies are often asymptomatic, they assume clinical importance during interventions such as central venous catheterisations and pacemaker implantations and during cardiothoracic surgeries while instituting cardiopulmonary bypass and for creation of cavo-pulmonary connections. Role of imaging in identifying these anomalies is indispensable. Cross-sectional imaging techniques like CT venography and magnetic resonance (MR) venography allow direct visualisation and consequently increased detection of anomalies. CT venography plays an important role in detection of SVC anomalies as it is readily available, has excellent spatial resolution, short acquisition times and potential for reconstruction of images in multiple planes. This pictorial review focuses on the developmental anomalies of the SVC and its tributaries highlighting their embryological basis, imaging appearances on CT venography and potential clinical implications, where relevant.

Pictorial Review: Cross-Sectional Imaging of the Foot and Ankle

Foot & Ankle ◽  
1987 ◽  
Vol 8 (2) ◽  
pp. 59-80 ◽  
Author(s):  
David J. Sartoris ◽  
Donald Resnick
Keyword(s):  
Imaging Techniques ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Foot And Ankle ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Pictorial Review ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Contrast Discrimination

Cross-sectional imaging techniques are becoming increasingly important for the evaluation of foot and ankle disorders. Computed tomography affords superior depiction of osseous anatomy, and is useful in the assessment of acute fractures, degenerative joint disease, and postoperative alterations. Magnetic resonance imaging is particularly well suited to soft tissue disease, including neoplasms, tendinitis, myopathy, and infection, owing to its excellent contrast discrimination capabilities.

scholarly journals Profil Des Infections Ostéoarticulaires En Consultation Rhumatologique Au CHU- Kara (Togo)

2017 ◽  
Vol 13 (27) ◽  
pp. 251
Author(s):  
Prénam Houzou ◽  
Kodjo Kakpovi ◽  
Eyram Fianyo ◽  
Viwalé Etonam S. Koffi-Tessio ◽  
Komi Cyrille Tagbor ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Cross Sectional ◽  
Retroviral Infection ◽  
Musculoskeletal Infection ◽  
Clinical Forms ◽  
Joint Infections ◽  
Osteoarticular Infections ◽  
Rheumatology Unit ◽  
Duration Of Disease ◽  
The Mean

Introduction: Osteoarticular infections remain public health problems in Africa. We aim at determining the clinical forms, topographic and etiological osteoarticular infections in a rheumatology unit of northern Togo. Methods: We conducted a cross-sectional study from April 2012 to March 2015 on inpatient records having suffered from musculoskeletal infection. Results: Of the 1813 patients admitted to the department in three years, 86 (4.74%) suffered from musculoskeletal infection. Of them, 36 (41.86%) were men and 50 (58.1% 4) were women, with a sex ratio (M/F) of 0.72. The mean age of the patients was 45 years. The mean duration of disease progression was 3.5 months. The different clinical forms observed were: spondylitis (47 patients, 54.65%), infectious arthritis (31 cases, 36.05%) and osteomyelitis (eight cases; 9.30%). The infection was likely tuberculous in 53 patients (61.63%), including 44 cases of Pott's disease. A banal germ was mentioned in the 33 others patients (38.37%). In four cases, the germ was isolated: Staphylococcus aureus (three cases) and Staphylococcus epidermidis (one case). The joints most affected by the infection were the hip (nine patients) and the knee (eight patients). Infection was multifocal in 14 cases (16.27%). The main risk factors for the infection identified were: promiscuity and poor hygiene (59.30%), alcoholism (26.74%) and retroviral infection (12.79%). Conclusion: This study and joint infections are a common reason for rheumatology consultation in northern Togo with a significant share of multifocal forms.

scholarly journals Contemporary clinical isolates of Staphylococcus aureus from pediatric osteomyelitis patients display unique characteristics in a mouse model of hematogenous osteomyelitis

2021 ◽  
Author(s):  
Philip M Roper ◽  
Kara R Eichelberger ◽  
Linda Cox ◽  
Luke O’Connor ◽  
Christine Shao ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Volume Fraction ◽  
Direct Injection ◽  
Clinical Isolates ◽  
Micro Computed Tomography ◽  
Bone Volume Fraction ◽  
Musculoskeletal Infection ◽  
Joint Infections ◽  
Hematogenous Osteomyelitis ◽  
Direct Inoculation

Osteomyelitis can result from the direct inoculation of pathogens into bone during injury or surgery, or from spread via the bloodstream, a condition called hematogenous osteomyelitis (HOM). HOM disproportionally affects children, and more than half of cases are caused by Staphylococcus (S.) aureus . Laboratory models of osteomyelitis mostly utilize direct injection of bacteria into the bone or the implantation of foreign material, and therefore do not directly interrogate the pathogenesis of pediatric hematogenous osteomyelitis. In this study, we inoculated mice intravenously and characterized resultant musculoskeletal infections using two strains isolated from adults (USA300-LAC and NRS384) and five new methicillin-resistant S. aureus isolates from pediatric osteomyelitis patients. All strains were capable of creating stable infections over five weeks, although the incidence varied. Micro-computed tomography (microCT) analysis demonstrated decreases in trabecular bone volume fraction but little effect on bone cortices. Histologic assessment revealed differences in the precise focus of musculoskeletal infection, with varying mixtures of bone-centered osteomyelitis and joint-centered septic arthritis. Whole genome sequencing of three new isolates demonstrated distinct strains, two within the USA300 lineage and one USA100 isolate. Interestingly, this USA100 isolate showed a distinct predilection for septic arthritis, compared to the other isolates tested, including NRS384 and LAC, which more frequently led to osteomyelitis or mixed bone and joint infections. Collectively, these data outline the feasibility of using pediatric osteomyelitis clinical isolates to study the pathogenesis of HOM in murine models and lay the groundwork for future studies investigating strain-dependent differences in musculoskeletal infection.

scholarly journals Imaging Features of Postradiotherapy Changes in Head and Neck Cancers

2021 ◽  
Author(s):  
Anisha Gehani ◽  
Saugata Sen ◽  
Sanjoy Chatterjee ◽  
Sumit Mukhopadhyay
Keyword(s):  
Head And Neck ◽  
Imaging Techniques ◽  
Neck Region ◽  
Head And Neck Cancers ◽  
Imaging Features ◽  
Recurrent Tumor ◽  
Cross Sectional ◽  
Head And Neck Region ◽  
Pictorial Essay ◽  
Cross Sectional Imaging

AbstractRadiation therapy is the mainstay in the treatment of head and neck cancers, in addition to surgery and chemotherapy. Expected radiotherapy changes evolving over time may be confused with recurrent tumor. Conversely, even residual or recurrent tumor in the setting of postradiotherapy changes may be difficult to identify clinically or even by radiological imaging. Therefore, it is important to be familiar with the temporal evolution of these changes. The purpose of this pictorial essay is thus to illustrate distinctly the expected radiotherapy changes and radiotherapy-related complications in the head and neck region and to differentiate them from tumor recurrence on routine cross-sectional imaging techniques (computed tomography and magnetic resonance imaging).

scholarly journals Tracking the glossopharyngeal nerve pathway through anatomical references in cross-sectional imaging techniques: a pictorial review

2018 ◽  
Vol 9 (4) ◽  
pp. 559-569 ◽  
Author(s):  
José María García Santos ◽  
Sandra Sánchez Jiménez ◽  
Marta Tovar Pérez ◽  
Matilde Moreno Cascales ◽  
Javier Lailhacar Marty ◽  
...  
Keyword(s):  
Imaging Techniques ◽  
Glossopharyngeal Nerve ◽  
Cross Sectional ◽  
Pictorial Review ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

scholarly journals Bone and Joint Infections in Children and Adolescents in Luanda, Angola

Osteology ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 80-85
Author(s):  
Markus Pääkkönen ◽  
Tuula Pelkonen ◽  
Guilhermino Joaquim ◽  
Luis Bernandino ◽  
Tiina Pöyhiä ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Blood Transfusion ◽  
Septic Arthritis ◽  
Surgical Procedures ◽  
Chart Review ◽  
Pathological Fracture ◽  
Retrospective Chart Review ◽  
Cell Disease ◽  
Joint Infections ◽  
Bone And Joint Infections

We reviewed the characteristics of children hospitalized for bone and joint infections in Luanda, Angola. In a retrospective chart review of 45 patients with childhood osteomyelitis or septic arthritis, 51% of the patients had sickle cell disease, and these patients presented with lower hemoglobin and needed blood transfusion more frequently (p < 0.05). Out of all patients, 64% underwent surgical procedures; a pathological fracture occurred in 31% of the patients.

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