scholarly journals Total Spine Magnetic Resonance Imaging for Detection of Multifocal Infection in Pyogenic Spondylodiscitis: a retrospective observational Study

2021 ◽  
Author(s):  
Jeanette Henkelmann ◽  
Timm Denecke ◽  
Philipp Pieroh ◽  
Stephanie Einhorn ◽  
Nicolas H. von der Hoeh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Multiple Infection ◽  
Lumbar Region ◽  
Mri Imaging ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Two Stage ◽  
Surgical Interventions

Abstract Background:Due to the unspecific symptoms of spondylodiscitis (SpD), an early radiological examination is necessary. However, controversially discussed is the need for magnetic resonance imaging of the entire spine to exclude multisegmental infections and to determine the required surgical interventions. The aims of this study were to assess the incidence of multilevel non-contiguous pyogenic SpD and compare comorbidities, pain symptoms, and subsequent surgical strategies between unifocal (uSpD) and multifocal (mSpD) SpD.Methods:We retrospectively evaluated the data of patients with confirmed, surgically treated, pyogenic SpD who had received a total spine MRI in a single spine center between 2016 and 2018. MRI findings were classified according to Pola-classification and demographics, duration of clinical symptoms (pain and neurology) and Charlson Comorbidity-Index (CCI) results were compared between uSpD und mSpD groups. Surgical therapy was evaluated in patients with mSpD. Results: uSpD was detected by MRI in 69 of 79 patients (87 %). Of these, mSpD was detected in 10 patients (13%) with 21 infected segments (cervical and/ or thoracic and/ or lumbar region). Age and CCI were similar between uSpD and mSpD and 24 of all SpD regions were clinically unapparent. All patients with uSpD were treated operatively. In seven patients with mSpD, all infected levels of the spine were treated surgically in a one-stage procedure; one patient had a two-stage procedure and one patient had surgery at the lumbar spine, and an additional infected segment of the upper thoracic spine was treated conservatively. One patient died before a planned two-stage procedure was performed.Conclusions:Due to mSpD being found in approximately 13% of SpD cases, and considering the risk of overlooking an mSpD case, MRI imaging of the total spine is recommended. The detection of multiple infection levels can have an impact on the therapeutic strategy chosen.

scholarly journals Total Spine Magnetic Resonance Imaging for Detection of Multifocal Infection in Pyogenic Spondylodiscitis: a retrospective observational Study

2020 ◽  
Author(s):  
Jeanette Henkelmann ◽  
Timm Denecke ◽  
Philipp Pieroh ◽  
Stephanie Einhorn ◽  
Nicolas H. von der Hoeh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Multiple Infection ◽  
Lumbar Region ◽  
Mri Imaging ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Two Stage ◽  
Surgical Interventions

Abstract Background Due to the unspecific symptoms of spondylodiscitis (SpD), an early radiological examination is necessary. However, controversially discussed is the need for an magnetic resonance imaging of the entire spine to exclude multisegmental infections and to determine the required surgical interventions. The aims of this study were to assess the incidence of multilevel non-contiguous pyogenic SpD and compare comorbidities, pain symptoms, and subsequent surgical strategies between unifocal (uSpD) and multifocal (mSpD) SpD. Methods We retrospectively evaluated the data of patients with confirmed, surgically treated, pyogenic SpD who had received a total spine MRI in a single spine center between 2016 and 2018. MRI findings were classified according to Pola-classification and demographics, duration of clinical symptoms (pain and neurology) and Charlson Comorbidity-Index (CCI) results were compared between uSpD und mSpD groups. Surgical therapy was evaluated in patients with mSpD. Results:  uSpD was detected by MRI in 69 of 79 patients (87%). Of these, mSpD was detected in 10 patients (13%) with 21 infected segments (cervical and/ or thoracic and/ or lumbar region). Age and CCI were similar between uSpD and mSpD and 24 of all SpD regions were clinically unapparent. All patients with uSpD were treated operatively. In seven patients with mSpD, all infected levels of the spine were treated surgically in a one-stage procedure; one patient had a two-stage procedure and one patient had surgery at the lumbar spine, and an additional infected segment of the upper thoracic spine was treated conservatively. One patient died before a planned two-stage procedure was performed. Conclusions Due to mSpD being found in approximately 13% of SpD cases, and considering the risk of overlooking an mSpD case, MRI imaging of the total spine is recommended. The detection of multiple infection levels can have an impact on the therapeutic strategy chosen.

scholarly journals Total spine magnetic resonance imaging for detection of multifocal infection in pyogenic spondylodiscitis: a retrospective observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jeanette Henkelmann ◽  
Timm Denecke ◽  
Philipp Pieroh ◽  
Stephanie Einhorn ◽  
Nicolas H. von der Hoeh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Multiple Infection ◽  
Lumbar Region ◽  
Mri Imaging ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Two Stage ◽  
Surgical Interventions

Abstract Background Due to the unspecific symptoms of spondylodiscitis (SpD), an early radiological examination is necessary. However, controversially discussed is the need for magnetic resonance imaging of the entire spine to exclude multisegmental infections and to determine the required surgical interventions. The aims of this study were to assess the incidence of multilevel non-contiguous pyogenic SpD and compare comorbidities, pain symptoms, and subsequent surgical strategies between unifocal (uSpD) and multifocal (mSpD) SpD. Methods We retrospectively evaluated the data of patients with confirmed, surgically treated, pyogenic SpD who had received a total spine MRI in a single spine center between 2016 and 2018. MRI findings were classified according to Pola-classification and demographics, duration of clinical symptoms (pain and neurology) and Charlson Comorbidity-Index (CCI) results were compared between uSpD und mSpD groups. Surgical therapy was evaluated in patients with mSpD. Results uSpD was detected by MRI in 69 of 79 patients (87%). Of these, mSpD was detected in 10 patients (13%) with 21 infected segments (cervical and/ or thoracic and/ or lumbar region). Age and CCI were similar between uSpD and mSpD and 24 of all SpD regions were clinically unapparent. All patients with uSpD were treated operatively. In seven patients with mSpD, all infected levels of the spine were treated surgically in a one-stage procedure; one patient had a two-stage procedure and one patient had surgery at the lumbar spine, and an additional infected segment of the upper thoracic spine was treated conservatively. One patient died before a planned two-stage procedure was performed. Conclusions Due to mSpD being found in approximately 13% of SpD cases, and considering the risk of overlooking an mSpD case, MRI imaging of the total spine is recommended. The detection of multiple infection levels can have an impact on the therapeutic strategy chosen.

scholarly journals Total Spine Magnetic Resonance Imaging for Detection of Multifocal Infection in Pyogenic Spondylodiscitis: A Retrospective Observational Study

2020 ◽  
Author(s):  
Jeanette Henkelmann ◽  
Timm Denecke ◽  
Philipp Pieroh ◽  
Stephanie Einhorn ◽  
Nicolas H. von der Hoeh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Multiple Infection ◽  
Lumbar Region ◽  
Mri Imaging ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Two Stage ◽  
Surgical Interventions

Abstract Background:Due to the unspecific symptoms of spondylodiscitis (SpD), an early radiological examination is necessary. However, controversially discussed is the need for an magnetic resonance imaging of the entire spine to exclude multisegmental infections and to determine the required surgical interventions. The aims of this study were to assess the incidence of multilevel non-contiguous pyogenic SpD and compare comorbidities, pain symptoms, and subsequent surgical strategies between unifocal (uSpD) and multifocal (mSpD) SpD. Methods:We retrospectively evaluated the data of patients with confirmed, surgically treated, pyogenic SpD who had received a total spine MRI in a single spine center between 2016 and 2018. MRI findings were classified according to Pola-classification and demographics, duration of clinical symptoms (pain and neurology) and Charlson Comorbidity-Index (CCI) results were compared between uSpD und mSpD groups. Surgical therapy was evaluated in patients with mSpD. Results: uSpD was detected by MRI in 69 of 79 patients (87 %). Of these, mSpD was detected in 10 patients (13%) with 21 infected segments (cervical and/ or thoracic and/ or lumbar region). Age and CCI were similar between uSpD and mSpD and 24 of all SpD regions were clinically unapparent. All patients with uSpD were treated operatively. In seven patients with mSpD, all infected levels of the spine were treated surgically in a one-stage procedure; one patient had a two-stage procedure and one patient had surgery at the lumbar spine, and an additional infected segment of the upper thoracic spine was treated conservatively. One patient died before a planned two-stage procedure was performed. Conclusions:Due to mSpD being found in approximately 13% of SpD cases, and considering the risk of overlooking an mSpD case, MRI imaging of the total spine is recommended. The detection of multiple infection levels can have an impact on the therapeutic strategy chosen.

scholarly journals Total Spine Magnetic Resonance Imaging for Detection of Multifocal Infection in Pyogenic Spondylodiscitis: a retrospective observational Study

2020 ◽  
Author(s):  
Jeanette Henkelmann ◽  
Timm Denecke ◽  
Philipp Pieroh ◽  
Stephanie Einhorn ◽  
Nicolas H. von der Hoeh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Multiple Infection ◽  
Lumbar Region ◽  
Mri Imaging ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Two Stage ◽  
Surgical Interventions

Abstract Background: Due to the unspecific symptoms of spondylodiscitis (SpD), an early radiological examination is necessary. However, controversially discussed is the need for magnetic resonance imaging of the entire spine to exclude multisegmental infections and to determine the required surgical interventions. The aims of this study were to assess the incidence of multilevel non-contiguous pyogenic SpD and compare comorbidities, pain symptoms, and subsequent surgical strategies between unifocal (uSpD) and multifocal (mSpD) SpD.Methods: We retrospectively evaluated the data of patients with confirmed, surgically treated, pyogenic SpD who had received a total spine MRI in a single spine center between 2016 and 2018. MRI findings were classified according to Pola-classification and demographics, duration of clinical symptoms (pain and neurology) and Charlson Comorbidity-Index (CCI) results were compared between uSpD und mSpD groups. Surgical therapy was evaluated in patients with mSpD. Results: uSpD was detected by MRI in 69 of 79 patients (87 %). Of these, mSpD was detected in 10 patients (13%) with 21 infected segments (cervical and/ or thoracic and/ or lumbar region). Age and CCI were similar between uSpD and mSpD and 24 of all SpD regions were clinically unapparent. All patients with uSpD were treated operatively. In seven patients with mSpD, all infected levels of the spine were treated surgically in a one-stage procedure; one patient had a two-stage procedure and one patient had surgery at the lumbar spine, and an additional infected segment of the upper thoracic spine was treated conservatively. One patient died before a planned two-stage procedure was performed.Conclusions: Due to mSpD being found in approximately 13% of SpD cases, and considering the risk of overlooking an mSpD case, MRI imaging of the total spine is recommended. The detection of multiple infection levels can have an impact on the therapeutic strategy chosen.

scholarly journals POS1160 BRUCELLAR SPONDYLODISCITIS: CLINICAL AND MAGNETIC RESONANCE IMAGING FINDINGS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 858.3-858
Author(s):  
C. Daldoul ◽  
N. El Amri ◽  
S. Laataoui ◽  
K. Baccouch ◽  
H. Zegaloui ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Back Pain ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Agglutination Test ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Weighted Image ◽  
Intense Signal

Background:Osteoarticular involvement is one of the most common complications of brucellosis and it can occur in up to two thirds of patients infected. Vertebral involvement during brucellosis is considered not only as the most prevalent localization but also as the most severe one.Objectives:The aim of the present study was to describe the clinical and the magnetic resonance imaging features of brucellar spondylodiscitis.Methods:We conducted a retrospective study including 21 patients who have been hospitalized for spinal brucellosis from 1998 to 2019. The diagnosis of brucellosis was based on clinical symptoms, MRI findings and isolation of brucella species in blood or tissue specimens and/or a positive Wright agglutination test.Results:Twenty-one patients were included. The mean age was 57.5 years [33-74] (13 males and 8 female). The geographical origin of the patients was rural in 76% of the cases. The median duration of symptoms progression before diagnosis was 4.5 months [1-8].The main symptom leading to seek medical care was an inflammatory back pain and it was found in all cases. It was associated with unilateral radiculopathy in 8 cases and with a bilateral radiculopathy in 1 case. The other clinical features found were fever in 17 patients, sweats in 14 cases, weight loss in 10 cases and hepatomegaly in 1 patient. The physical examination revealed tenderness on palpation in 12 cases, a motor weakness of the two lower limbs in 2 cases. Brucella agglutination test was ≥1/160 in all cases. Blood cultures were negative in all cases. The median erythrocyte sedimentation rate (ESR) and serum C-reactive protein level were 40 mm and 11mg/dl) respectively. Spondylodiscitis was located in the lumbar dorsal and cervical spine in respectively 10, 8 and 3 cases. The most affected level was the L4-L5 level in 5 cases followed by the T10-T11 level in 3 cases. The involvement of more than 2 vertebrae was found in 4 cases. Associated sacroiliitis was found in one patient. All MRI images of the affected vertebrae showed hypo intense signal on T1 weighted image and hyper intense signal on T2 weighted image. Disc space narrowing was found in 8 cases. Vertebral body osteolysis was found in 10 cases. Epidural collection was documented in 3 cases with a size up to 5cm. Paravertebral and peri-vertebral abscesses were detected in 5 cases. Intradiscal abscesses were observed in 3 cases. Cord compression and involvement of root nerve were noted in respectively 5 and 1 cases. Biopsy was performed in 5 cases, but bacteriological examination was contributory to the diagnosis in 1 case. All patients received antibiotic treatment with a combination of two or three drugs, corticosteroids were prescribed in 5 patients and one patient underwent a surgical intervention. The evolution was good 16 in patients, three patients suffered from chronic back pain, one patient had persistent neuropathic pain and one patient had paresis.Conclusion:Brucella spondylodicitis is still a serious public health problem in developing countries. MRI findings associated with clinical symptoms may establish the diagnosis even if bacteriological examinations are negativesDisclosure of Interests:None declared.

Magnetic Resonance Imaging Findings and Clinical Outcomes in the Early Postoperative Period after Full Endoscopic Diskectomy for Lumbar Disk Herniation

2021 ◽  
Author(s):  
Tomoya Terai ◽  
Takashi Chikawa ◽  
Tatsuhiko Henmi ◽  
Koichi Sairyo
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Postoperative Period ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Japanese Orthopaedic Association ◽  
Early Postoperative Period ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Postoperative Mri

Abstract Introduction This prospective case-control study aimed to establish the normal spectrum of early magnetic resonance imaging (MRI) findings in patients whose symptoms resolve after full endoscopic diskectomy (FED). We examined the changes in postoperative MRI findings and their relation to early clinical symptoms. Methods In total, 33 patients underwent FED under local anesthesia. Clinical assessments and MRI examinations were performed preoperatively and immediately (within 1 week) and late (at 3 and 12 months) postoperatively. Residual disk bulging after surgery was classified into four grades compared with preoperative MRI findings: none (grade A), <25% (grade B), 25–75% (grade C), and >75% (grade D). Results MRI at postoperative week 1 showed grade B residual disk bulging in 9 patients, grade C residual disk bulging in 8 patients, and grade D residual disk bulging in 16 patients. Improvement was seen at postoperative month 3 (grade A in 18 patients, grade B in 10 patients, and grade C in 5 patients) and at postoperative month 12 (grade A in 29 patients, grade B in 3 patients, and grade C in 1 patient). Visual analog scale scores and the Japanese Orthopaedic Association scores showed significant differences at 1 week, 3 months, and 12 months after surgery. Conclusion Postoperative MRI findings within 1 week of FED showed grade C or D residual disk material in 24 of 33 patients (73%). Clinical symptoms improved in the early postoperative period, even though residual disk bulging was present. Persisting residual bulging in the early stage following surgery may not correlate with clinical symptoms.

Computed Tomography and Magnetic Resonance Imaging-aided Diagnosis of Primary Essential Cutis Verticis Gyrata: A Case Report with 5-year Follow-up and Review of the Literature

2019 ◽  
Vol 15 (9) ◽  
pp. 906-910
Author(s):  
Hongzhang Zhu ◽  
Shi-Ting Feng ◽  
Xingqi Zhang ◽  
Zunfu Ke ◽  
Ruixi Zeng ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Three Dimensional ◽  
Stable Condition ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Cutis Verticis Gyrata ◽  
Essential Form ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

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.

scholarly journals Balo’s Concentric Sclerosis Mimicking Tumor on Magnetic Resonance Imaging in a Young Patient

2021 ◽  
Vol 14 ◽  
pp. 117954762198967
Author(s):  
Van Trung Hoang ◽  
Cong Thao Trinh ◽  
Hoang Anh Thi Van ◽  
Thanh Tam Thi Nguyen ◽  
Vichit Chansomphou ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Demyelinating Disease ◽  
Management Strategies ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Demyelinating Lesions ◽  
Baló’S Concentric Sclerosis ◽  
Magnetic Resonance Imaging Mri ◽  
Subcortical Regions

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.

scholarly journals Relationship between abnormalities detected by magnetic resonance imaging and knee symptoms in early knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seiya Ota ◽  
Eiji Sasaki ◽  
Shizuka Sasaki ◽  
Daisuke Chiba ◽  
Yuka Kimura ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Knee Osteoarthritis ◽  
Cartilage Damage ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Radiographic Evidence ◽  
Cross Sectional ◽  
Meniscal Lesions ◽  
Magnetic Resonance Imaging Mri

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.

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