Low-Field MR Imaging for the Assessment of Therapy Response in Musculoskeletal Infections

1995 ◽  
Vol 36 (3) ◽  
pp. 220-227 ◽  
Author(s):  
I. Hovi ◽  
M. Valtonen ◽  
O. Korhola ◽  
P. Hekali
Keyword(s):  
Mr Imaging ◽  
Therapy Response ◽  
C Reactive Protein ◽  
Musculoskeletal Infection ◽  
Reactive Protein ◽  
Low Field ◽  
Erythrocyte Sedimentation ◽  
Follow Up Studies ◽  
Wbc Count

Fifty-one patients with musculoskeletal infection were imaged by repeated MR imaging at ultra low-field and low-field strength. Soft-tissue infection, osteomyelitis, septic arthritis, and spondylitis were studied. The MR finding was scored according to the signal intensity (SI) on T2-weighted images (T2WI), and correlated with the values of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and peripheral white blood cell (WBC) count. There was a positive correlation between the MR score and both CRP and ESR, but no correlation between MR score and WBC. The MR score between the follow-up studies decreased significantly in accordance with clinical reconstitution. The MR finding according to the SI on T2WIs corresponded better to disease activity than did the CRP or ESR.

scholarly journals One-Stage Anterolateral Debridement, Bone Grafting, and Internal Fixation for Treating Lumbosacral Tuberculosis

2017 ◽  
Vol 11 (2) ◽  
pp. 305-313 ◽  
Author(s):  
Tao Zhang ◽  
Lihua Ma ◽  
Xu Lan ◽  
Ping Zhen ◽  
Shiyong Wang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Bone Grafting ◽  
Oswestry Disability Index ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
One Stage ◽  
Erythrocyte Sedimentation

<sec><title>Study Design</title><p>Retrospective case series.</p></sec><sec><title>Purpose</title><p>To investigate the clinical efficacy and feasibility of one-stage anterolateral debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis.</p></sec><sec><title>Overview of Literature</title><p>There has been no consensus regarding the optimal means of treating lumbosacral tuberculosis. The one-stage anterolateral extraperitoneal approach for radical debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis is rare in literature.</p></sec><sec><title>Methods</title><p>Twenty-one patients with lumbosacral tuberculosis were retrospectively analyzed. All patients underwent the surgery of anterolateral debridement after regularly antituberculous drugs therapy. We evaluated the erythrocyte sedimentation rate, C-reactive protein, radiography, computed tomography, magnetic resonance imaging, visual analogue score, and Oswestry disability index before and after surgery.</p></sec><sec><title>Results</title><p>All patients completed a follow-up survey 9–48 months after surgery. All patients' wounds healed well without chronic infection or sinus formation, and all patients with low-back pain reported relief after surgery. All cases had no tuberculosis recurrence. Solid bony fusion was achieved within 6–12 months. At final follow-up, evaluated the erythrocyte sedimentation rate decreased from 38.1±12.5 to 11.3±7.1 mm/hr, C-reactive protein decreased from 6.2±4.2 to 1.6±1.3 mg/dL, the visual analog scale score decreased from 4.6±1.1 to 1.4±1.0, the Oswestry disability index score decreased from 50.2%±11.9% to 13.0%±6.6%, and the lumbosacral angle increased from 20.0°±4.8° to 29.0°±3.9° (<italic>p</italic>&lt;0.05).</p></sec><sec><title>Conclusions</title><p>One-stage anterolateral debridement, bone grafting, and internal instrument fixation for treating lumbosacral tuberculosis is safe and effective.</p></sec>

scholarly journals Sclerosing osteomyelitis of Garré: A confusing clinical diagnosis

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987470
Author(s):  
Seungcheol Song ◽  
Hwa Jae Jeong ◽  
Hun-Kyu Shin ◽  
Eegene Kim ◽  
Se-Jin Park ◽  
...  
Keyword(s):  
Proximal Femur ◽  
Chronic Osteomyelitis ◽  
Magnetic Resonance Images ◽  
Thigh Pain ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Lower Back ◽  
Erythrocyte Sedimentation ◽  
The Right

We describe a rare case of sclerosing osteomyelitis of Garré in a 63-year-old woman with uncontrolled right thigh pain. She had suffered from lower back pain and radiating pain on the right lower leg for a year and 4 months and so had spine surgery 8 months ago. But the right thigh pain persisted, and the levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) remained abnormal. Right femur radiographs showed cortical thickening on the proximal femur. Magnetic resonance images showed T2 hypersignal intensity lesions in the proximal femur. Under suspicion of osteoid osteoma or sclerosing osteomyelitis, surgery was performed with biopsy, bone curettage, and drilling. The culture was negative, and the biopsy showed chronic osteomyelitis. Despite surgery, the levels of CRP and ESR still remained abnormal. After using venous antibiotics, the pain subsided and CRP and ESR levels turned to normal. Followed by 6 weeks of oral antibiotics, pain was relieved after 1-year follow-up.

scholarly journals 1249. Images vs. C-Reactive Protein Follow-up of Patients with Organ/space Surgical Site Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S449-S449
Author(s):  
Natalia Garcia Allende ◽  
Cristina Freuler ◽  
Ana Victoria Sanchez ◽  
Cecilia Ezcurra ◽  
Micaela Mayer Wolf ◽  
...  
Keyword(s):  
Imaging Study ◽  
Surgical Site Infections ◽  
Antimicrobial Treatment ◽  
Average Score ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
End Of Treatment ◽  
Intra Abdominal Infection

Abstract Background End-of-treatment images of infections after intra-abdominal infection could increase costs. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are used to define and predict the evolution of infectious diseases. The aim of this study was to describe clinical outcomes of adult patients with end-of-treatment images or CRP and ESR follow-up, during treatment of organ/space (OS) (intra-abdominal) surgical site infection (SSI). Methods Observational retrospective cohort. Hospitalized patients older than 16 years were included, who developed OS SSI after abdominal surgery, in a general hospital, from June 2014 to June 2018. Population variables: age, gender, comorbidities (cancer, diabetes mellitus, cirrhosis, chronic renal failure, tobacco, immunosuppressants, Charlson score and obesity), ESR, quantitative CRP, imaging study (tomography (CT)/ ultrasound), type of drainage route (surgical, percutaneous). Outcomes variables: antibiotic patient-days, time to infection (TTI), CRP and ESR at the time of diagnosis (TD) and at the end of treatment (TET), rate of relapsing infection. Statistical analysis: Description of variables sort by patients under images follow-up and patients under CRP and ESR follow-up. Fisher test of relapsing infection was calculated between groups. Results Included: 76 patients. Twenty-six were followed with CT or ultrasound and 50 were followed with CRP and ESR. Forty women, with a mean age of 55 years (19–91) and an average score of the Charlson of 3.64 (0–10). Forty patients had cancer before surgery (52.63%). Microbiological diagnosis: 70/76 patients, the majority was polymicrobial. Average of antibiotics patient-days was 24.4 days (14 days of intravenous therapy). TTI: 8.65 days. Average CRP at the TD was 87.5 mg/L and 17.5 mg/L at TET. No differences in ESR values (31.9 mm to 33.5 mm). Percutaneous drainage: 46 patients. Surgical procedure: 27. Relapsing infection: 11,5% in images group vs. 4% in no images group; P = 0.33. Conclusion Quantitative CRP monitoring was useful to guide the duration of antimicrobial treatment. No differences of relapsing infection between groups was found. Disclosures All authors: No reported disclosures.

scholarly journals An assessment of the C-reactive protein, erythrocyte sedimentation rate and white blood cell count, values during the post-operative period of infected tibial nonunions treated with antibiotic- loaded PMMA-coated nails

2021 ◽  
Vol 7 (3) ◽  
pp. 644
Author(s):  
Ferdi Dırvar ◽  
Raşit Özcafer ◽  
Kubilay Beng
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
Sedimentation Rate ◽  
Postoperative Period ◽  
C Reactive Protein ◽  
Blood Cell Count ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Significant Difference

<p>In this study, our aim was to assess the changes in the serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell count (WBC) values during the follow-up period of infected tibial pseudoarthrosis treated using antibiotic-loaded nails. Three patients with infected femoral nonunions and 11 patients with infected tibial nonunions were included in the study. All patients were treated with intramedullary nails coated with antibiotic-loaded PMMA after local extensive debridement. Postoperatively, parenteral antibiotic therapy was administered. The CRP, ESR and WBC values were noted preoperatively and on the first day, and then on the second, sixth, and 12<sup>th</sup> weeks postoperatively. The changes in these values over time were analyzed comparatively. The preoperative CRP level was found to be significantly lower than the early postoperative period (1<sup>st</sup> day), while no significant differences were detected during the follow-up period. The CRP level constantly decreased between the first postoperative control (1<sup>st</sup> day) and the final follow-up time (12<sup>th</sup> week). The postoperative ESR showed a significant difference when compared to the preoperative value, and also showed a decreasing trend in the postoperative period, having its highest value on the first day. The WBC did not exhibit a significant difference when comparing the preoperative and postoperative values. C-reactive protein level and ESR can be used to monitor the adequacy of the treatment after antibiotic-loaded nail application, whereas WBC may be insufficient in the diagnosis and follow-up of osteomyelitis treated with antibiotic-loaded nails.</p>

Oral Antibiotics for Treating Children With Community-Acquired Pneumonia Complicated by Empyema

2019 ◽  
Vol 58 (13) ◽  
pp. 1401-1408 ◽  
Author(s):  
Lauren E. Kushner ◽  
Delma J. Nieves ◽  
Stephanie Osborne ◽  
Hita Vora ◽  
Antonio Arrieta ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Treatment Success ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Length Of Treatment ◽  
Erythrocyte Sedimentation ◽  
End Of Treatment ◽  
Wbc Count ◽  
Serial Measurements

No consensus exists on management of children with community-acquired pneumonia complicated by empyema (CAP-Em). We evaluated outpatient oral (O-Abx) compared with parenteral antibiotics (OPAT) in children with CAP-Em. We also evaluated inflammatory markers to guide length of treatment. We conducted a retrospective cohort study of patients discharged (2006-2016) with CAP-Em. Primary outcome measured was treatment success (no change in antibiotics or readmission to hospital for treatment of CAP-Em). White blood cell (WBC) count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) serial measurements were identified. Success was achieved in 133/144 (92.4%) O-Abx and 7/12 (58%) OPAT patients ( P = .0031). WBC and CRP decreased early; and ESR increased initially (admit and switch to O-Abx) and decreased by end of treatment. O-Abx is the modality of choice for treatment of CAP-Em after hospital discharge. WBC and CRP are useful to monitor success of O-Abx switch; and ESR provides guidance for length of treatment.

Serum C-Reactive Protein, Erythrocyte Sedimentation Rate, and White Blood Cell Count in Acute Hematogenous Osteomyelitis of Children

PEDIATRICS ◽  
1994 ◽  
Vol 93 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Leila Unkila-Kallio ◽  
Markku J.T. Kallio ◽  
Heikki Peltola ◽  
Juhani Eskola
Keyword(s):  
Blood Cell ◽  
Mean Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis ◽  
The Mean ◽  
Wbc Count ◽  
Time Of Admission

Objective. The aim of this prospective study was to compare the clinical value of the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cell (WBC) count in diagnosis and follow-up of acute hematogenous osteomyelitis in children. Design. Forty-four children aged 2 weeks to 14 years with bacteriologically confirmed acute hematogenous osteomyelitis were examined. Staphylococcus aureus was responsible in 39 cases (89%), Haemophilus influenzae type b in 3 cases (7%), pneumococcus in 1 case (2%), and a microaerophilic streptococcus in 1 case (2%). ESR was measured at the time of admission and on days 3, 5, 7, 10, 14, 19, and 29 of treatment, and CRP was measured on the same days as ESR but also on days 2, 9, 12, 17, and 23. WBC count was examined at the time of admission and on days 5, 10, 19, and 29. Results. ESR was elevated (≥20 mm/h) initially in 92% of the cases; the mean value was 45 mm/h, and the peak values (mean 58 mm/h) were reached on days 3 to 5. After this the levels slowly returned to normal in approximately 3 weeks (mean 18 days). CRP was elevated (&gt;19 mg/L) at the time of admission in 98% of the cases, the mean value being 71 mg/L. The peak CRP value was reached on day 2 (mean 83 mg/L). The decrease was very rapid, normal values being reached within a week (mean 6.9 days). The WBC count was a poor indicator of acute hematogenous osteomyelitis, since only 35% of the children had leukocytosis (WBCs &gt; 12 x 109/L) at the time of admission. Conclusions. In patients with acute hematogenous osteomyelitis, CRP increased and especially decreased significantly faster than ESR, reflecting the effectiveness of the therapy given and predicting recovery more sensitively than ESR or WBC count.

scholarly journals Clinical and CT Characteristics of Medical Personnel with the Coronavirus Disease-2019 (COVID-19) in Wuhan

2020 ◽  
Author(s):  
Ying Xiong ◽  
Qiang Zhang ◽  
Dong Sun ◽  
Xiaoming Li ◽  
Wenzhen Zhu
Keyword(s):  
Clinical Laboratory ◽  
Early Stage ◽  
Medical Personnel ◽  
C Reactive Protein ◽  
Illness Onset ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Clinical Laboratory Test ◽  
Ct Features

Abstract Objectives: To investigate the clinical and chest CT characteristics of medical personnel infected with the Coronavirus Disease-2019 (COVID-19).Methods: The clinical, laboratory test and computed tomography (CT) features of 30 medical personnel (MP group, 26-65 years, 16 males) with COVID-19 were retrospectively analyzed, and compared to 33 non-medical related patients (non-MP group, 26-74 years, 19 males). Follow-up CT characteristics were analyzed to assess the changes of the COVID-19 infection in the period of hospitalization.Results: At admission, the main complaints of MP group, including fever (86.7%), fatigue (53.3%) and cough (43.3%), were similar to the non-MP group; the C-reactive protein, erythrocyte sedimentation rate and lactate dehydrogenase levels of the non-MP group (55.6±45.9mg/L, 34.7±26.3mm/H and 321±117U/L) were higher than that of the MP group (17.8±19.9mg/L, 18.6±21.3mm/H and 219±54.2U/L, respectively, all p<0.05). Ground-grass opacities, consolidation, interstitial thickening were common CT features of both groups. The days from illness onset to the first CT exam, and the severity of opacities on initial CT were less in the MP group than that of the non-MP group (p<0.05). However, the days from onset to observation of the most obvious pulmonary opacities, according to CT findings, were similar in the MP group (11.5±5.9 days) and the non-MP group (12.2±3.1 days, p=0.55).Conclusions: Like the general population, medical personnel are also susceptible to the COVID-19, although with more professional knowledge and protective equipment. Occupational exposure is a very important factor. Medical personnel have a higher vigilance about the infection in the early stage of the disease.

scholarly journals Do Brucella Antibody Titers Correlate with Clinical Outcomes and Culture Positivity of Brucellosis?

2019 ◽  
Author(s):  
Shahad A. Alsubaie ◽  
Shouq A. Turkistani ◽  
Alanoud A. Zeaiter ◽  
Abrar K. Thabit
Keyword(s):  
Clinical Outcomes ◽  
Clinical Picture ◽  
Healthcare Providers ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Culture Positivity ◽  
Antibody Titers ◽  
Wbc Count ◽  
Serology Testing

AbstractBrucellosis is a zoonotic disease caused by Brucella spp., namely B. meletinsis and B. abortus in humans. Studies on the correlation between Brucella antibody titers and clinical outcomes are limited. Therefore, this study assessed such correlation and evaluated the correlation between baseline serologic results with culture positivity and clinical picture. Patients tested positive for Brucella antibodies at baseline and diagnosed with brucellosis between January 2008 and December 2018 were included. Collected data included clinical outcomes, baseline culture positivity, arthralgia, baseline and EOT temperature, white blood cell (WBC) count, C-reactive protein level, and erythrocyte sedimentation rate. Of 695 patients tested for Brucella antibodies, only 94 had positive baseline serology and diagnosed with brucellosis, among whom 63 had EOT serology. No significant correlations were found between EOT antibody titers of both Brucella spp. and clinical cure, mortality, length of stay, and duration of therapy. Additionally, no correlations were found between baseline serology and culture positivity, arthralgia, temperature, and other lab values. Brucella serology does not correlate with clinical outcomes at EOT nor with culture positivity at baseline. Therefore, healthcare providers are advised to consider the whole clinical picture of a brucellosis patient without relying solely on serologic results during follow up and not replace culturing with serology testing alone at the time of diagnosis.

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