Magnetic resonance imaging evaluation of posterior spinal tuberculosis: a cross-sectional study

2020 ◽  
pp. 028418512094849
Author(s):  
Deb K Boruah ◽  
Bidyut B Gogoi ◽  
Arjun Prakash ◽  
Navneet R Lal ◽  
Karuna Hazarika ◽  
...  

Background Isolated posterior spinal (element) tuberculosis (TB) is uncommon compared to classical anterior spinal or para-discal TB. Here, we report magnetic resonance imaging (MRI) findings of posterior spinal TB in 19 patients without involvement of the vertebral body and intervertebral disc. Purpose To evaluate the MRI findings in isolated posterior spinal (element) TB. Material and Methods Clinical and MRI data of 19 patients of isolated posterior spinal TB were retrospectively evaluated. Results Of the 19 patients, group A comprised 4 (21%) patients with rapid onset lower limb weakness and pyramidal signs while group B comprised 15 (79%) patients without any neurological deficit. Lumbar vertebrae commonly affected 9 (47.4%) patients followed by dorsal vertebrae in 8 (42.1%) patients and cervical vertebrae in 2 (10.5%) patients. The pedicle was most commonly involved in 12 (63.2%) patients followed by the lamina in 11 (58%) patients, and spinous process and facet joint in 6 (31.6%) patients each. Extra-spinal inflammation/pyomyositis/paraspinal abscess was found in 13 (68.4%) patients followed by epidural abscess 3 (15.8%) patients and both extra spinal inflammation and epidural abscess in 3 (15.8%) patients (15.8%). Compressive cord myelopathy was observed in 4 (21%) patients, where three patients underwent emergency decompression laminectomy and the remaining 16 patients were treated conservatively with anti-tubercular therapy. Conclusion Initial diagnosis of isolated posterior element TB is challenging and requires a high index of suspicion. Early diagnosis of isolated posterior spinal TB is important as early treatment may be beneficial and decreases patient morbidity.

2014 ◽  
Vol 27 (02) ◽  
pp. 155-158 ◽  
Author(s):  
U. Geissbühler ◽  
P. Karli ◽  
F. Forterre ◽  
E. Linon

SummaryA two-year-old female Lucerne Hound was presented with a one-week history of signs of progressive neck pain, inappetence, apathy, and an elevated rectal temperature. Findings of magnetic resonance imaging (MRI) were consistent with a foreign body abscess in the epidural space at the level of the first and second cervical vertebrae. A leftsided dorso-lateral atlantoaxial approach was performed, revealing an epidural abscess containing a grass awn. The clinical signs resolved within three days of surgery and the dog made a full recovery. This case report shows that grass awns can migrate to the atlantoaxial region in dogs and MRI findings lead to a suspicion of caudo-cranial migration within the spinal canal.


2021 ◽  
Author(s):  
Qiaofeng Chen ◽  
Shanpeng Wu ◽  
Tianxiang Lu ◽  
Jianhui Shi

Abstract Background: Spinal infection and tumor have abnormal magnetic resonance imaging (MRI) manifestations in the early stages; however, they are not easy to identify before symptoms appear. These conditions have their own characteristics and need to be correctly diagnosed.Methods: MRI images of six cases of pyogenic spondylitis, eight cases of tuberculous spondylitis, eight cases of Brucella spondylitis, and twelve cases of spinal tumor were reviewed. MRI images of the involved vertebral body, vertebral facet joint, spinous process, paravertebral soft tissue, and posterior dural sac of the vertebral body were analyzed using T2-weighted imaging, T1-weighted imaging, lipgraphy and enhanced MRI, respectively. Results: MRI data of spinal infection, spinal tuberculosis, spinal tumor, and spinal Brucella infection differed in their characteristics.Conclusions: MRI could provide early diagnostic evidence for spinal lesions.


2018 ◽  
Vol 1 (2) ◽  
pp. 19
Author(s):  
Sabri Ibrahim

Tuberculosis of the cervical spine is a rare clinical condition (10%), most commonly affected lower thoracic region (40-50% of the cases). Spinal tuberculosis is a destructive form of tuberculosis. It accounts for approximately half of all cases of musculoskeletal tuberculosis. Spinal tuberculosis is more common in children and young adults. The incidence of spinal tuberculosis is increasing in developed nations. Characteristically, there is a destruction of the intervertebral disk space and the adjacent vertebral bodies, collapse of the spinal elements, and anterior wedging leading to kyphosis and gibbus formation. For the diagnosis of spinal tuberculosis, magnetic resonance imaging is more sensitive than x-ray and more specific than computed tomography. Magnetic resonance imaging frequently demonstrates an involvement of the vertebral bodies on either side of the disk, disk destruction, cold abscess, vertebral collapse, and presence of vertebral column deformities. Anti-tuberculous treatment remains the cornerstone of treatment. Surgery may be required in selected cases, e.g. large abscess formation, severe kyphosis, an evolving neurological deficit, or lack of response to medical treatment. The quality of debridement and bony fusion is optimal when the anterior approach is used. Posterior fixation is the best means of achieving reduction followed by stable sagittal alignment over time. With early diagnosis and early treatment, the prognosis is generally good.


Author(s):  
Hongzhang Zhu ◽  
Shi-Ting Feng ◽  
Xingqi Zhang ◽  
Zunfu Ke ◽  
Ruixi Zeng ◽  
...  

Background: Cutis Verticis Gyrata (CVG) is a rare skin disease caused by overgrowth of the scalp, presenting as cerebriform folds and wrinkles. CVG can be classified into two forms: primary (essential and non-essential) and secondary. The primary non-essential form is often associated with neurological and ophthalmological abnormalities, while the primary essential form occurs without associated comorbidities. Discussion: We report on a rare case of primary essential CVG with a 4-year history of normal-colored scalp skin mass in the parietal-occipital region without symptom in a 34-year-old male patient, retrospectively summarizing his pathological and Computer Tomography (CT) and magnetic resonance imaging (MRI) findings. The major clinical observations on the CT and MR sectional images include a thickened dermis and excessive growth of the scalp, forming the characteristic scalp folds. With the help of CT and MRI Three-dimensional (3D) reconstruction techniques, the characteristic skin changes could be displayed intuitively, providing more evidence for a diagnosis of CVG. At the 5-year followup, there were no obvious changes in the lesion. Conclusion: Based on our observations, we propose that not all patients with primary essential CVG need surgical intervention, and continuous clinical observation should be an appropriate therapy for those in stable condition.


2021 ◽  
Vol 14 ◽  
pp. 117954762198967
Author(s):  
Van Trung Hoang ◽  
Cong Thao Trinh ◽  
Hoang Anh Thi Van ◽  
Thanh Tam Thi Nguyen ◽  
Vichit Chansomphou ◽  
...  

Balo’s concentric sclerosis (BCS) is a rare demyelinating disease known as Multiple Sclerosis (MS) lesion type III. It is a disease of the white matter of the brain characterized by a round lesion with variable concentric myelinated and demyelinated layers, appearing as “onion bulb.” We present a case of BCS and discuss the imaging findings and management strategies of this disease. A 26-y-old male developed headache, weakness, and numbness of limbs. Magnetic resonance imaging (MRI) showed concentric lamellar like demyelinating lesions at the subcortical regions. The patient’s neurological symptoms were consistent with the MRI findings.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seiya Ota ◽  
Eiji Sasaki ◽  
Shizuka Sasaki ◽  
Daisuke Chiba ◽  
Yuka Kimura ◽  
...  

AbstractWe investigated the prevalence of magnetic resonance imaging (MRI) findings and their relationship with knee symptoms in women without radiographic evidence of knee osteoarthritis (KOA). This cross-sectional cohort study included 359 Japanese women without radiographic evidence of KOA (Kellgren‒Lawrence grade < 2). All participants underwent T2-weighted fat-suppressed MRI of their knees. Structural abnormalities (cartilage damage, bone marrow lesions [BMLs], subchondral cysts, bone attrition, osteophytes, meniscal lesions, and synovitis) were scored according to the whole-organ MRI score method. Knee symptoms were evaluated using the Knee Injury and Osteoarthritis Outcome Score. Participants were divided into early and non-KOA groups based on early KOA classification criteria. Logistic regression analysis was performed to evaluate the relationship between MRI abnormalities and knee symptoms. Cartilage damage was the most common abnormality (43.5%). The prevalences of cartilage damage, BMLs, subchondral cysts, bone attrition, meniscal lesions, and synovitis were higher in patients with early KOA than in those without. Synovitis (odds ratio [OR] 2.254, P = 0.002) and meniscal lesions (OR 1.479, P = 0.031) were positively associated with the presence of early KOA. Synovitis was most strongly associated with knee pain and might be a therapeutic target in patients with early KOA.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 694.2-694
Author(s):  
R. D. Vargas Ruíz ◽  
J. A. Gómez Rosero ◽  
C. Muñoz ◽  
D. Jaramillo Arroyave ◽  
L. Hernandez ◽  
...  

Background:muscle involvement is frequently reported in polyarteritis nodosa (PAN), mostly as myalgia, muscle swelling, and gait difficulty due to intramuscular arteries involvement, peripheral neuropathy, or myositis with slightly or no elevation of muscle enzymes. Magnetic resonance imaging (MRI) findings of compromised muscles have been reported in isolated cases, mainly as a limited form of PAN, however, muscular involvement patterns in MRI of patients with PAN have been recently describedObjectives:to describe MRI of legs findings in patients with PAN in a tertiary center from Medellin-Colombia.Methods:it was performed a retrospective cross-sectional descriptive study of 15 adult patients who were clinically assessed as having PAN and who had undergone MRI of legs between January 2011 and December 2019. Characteristics already informed in previous studies, affected structures (muscle, subcutaneous tissue, and bone) and pattern of hyperintensities were described as diffuse pattern (signal alterations affecting the entire area of the involved muscle), patched pattern (areas of hyperintensities alternating areas of normal muscle signal intensity), and fluffy nodular pattern or cotton-wool appearance (round hyperintense lesions with fluffy margins centered on blood vessels).Results:clinical characteristics:myalgia, especially calf pain, was the most frequent muscular complaint; other clinical manifestations were: constitutional symptoms (80%), arthralgias or arthritis (50%), mono/polyneuropathy (33%), subcutaneous nodules (33%), livedo reticularis (20%), lower limbs ulcers (13%), abdominal symptoms (13%), and purpura (7%).MRI findings:bilateral muscular edema was found in all patients (100%), fatty infiltration (20%), edema of the subcutaneous cellular tissue (20%), and muscular atrophy (13%) were also described. A diffuse pattern occurred in 46% (n=7) of patients (figure panel A), a patched pattern (figure panel B) in 46% (n=7), and a fluffy nodular pattern or cotton-wool appearance (figure panel C) in 6% (n=1). The most frequently affected muscular group was gastrocnemius and soleus (67%), followed by anterior tibialis (27%), plantar, long peroneus, first finger flexors, and long flexors only affected in 7%. Bone involvement was found in 53%, being the tibia the most affected, followed by the fibula and the calcaneus. MRI led to guide the site of muscle biopsy to prove histological medium-size vasculitis in half of the patients.Conclusion:in patients with PAN suspicion who have muscular complaints, especially calf pain, MRI arises as an important diagnostic tool, and also as a guide to muscular biopsy to prove vasculitis. The patterns associated with PAN are diffuse, patched or fluffy nodular hyperintensities in gastrocnemius and soleus with or without bone compromise.References:[1]Kang, Y. et al. Muscle involvement in polyarteritis nodosa: Report of eight cases with characteristic contrast enhancement pattern on MRI. Am. J. Roentgenol. 206, 378–384 (2016).[2]Hofman DM, Lems WF, Witkamp TD, Putte VD, Bijlsma JW. Demonstration of calf abnormalities by magnetic resonance imaging in polyarteritis nodosa. Clin Rheumatol 1992; 11:402–404.FigureDisclosure of Interests:None declared


Author(s):  
Sebnem Karasu ◽  
Atilla Hikmet Cilengir ◽  
Irfan Ocal ◽  
Serpil Aydogmus

Background: Vaginal adenosis is a rare clinicopathological entity which refers to the presence of glandular endometrial tissue in the vaginal wall. Case report: A gravida 46-year-old woman was presented to the gynecology department with symptoms of chronic pelvic pain. Maternal Diethylstilbestrol (DES) usage has been proven effective in the development of vaginal adenosis. It can also be idiopathic. Its sonographic or magnetic resonance imaging (MRI) findings have not been described in English literature previously. Conclusion: Here, we report the clinical, transperineal ultrasonographic (US) and MRI findings of a pathologically proven case of vaginal adenosis.


Sign in / Sign up

Export Citation Format

Share Document