The findings in 44 patients with back pain and brucellosis are described. Radiological changes tended to occur in older patients with a longer duration of disease. The younger patients more often experienced an acute arthritis with sacroiliitis resembling a reactive disease. Bone scanning was more sensitive than radiographs, particularly in detecting acute sacroiliitis and hip involvement. The lumbar spine was the most frequently involved site although no part of the spine was spared. Extensive destruction of a vertebral body with little involvement of the adjacent vertebrae, lower lumbar spondylolysis and spondylolisthesis, and discitis with calcification were striking radiological findings hitherto undescribed in brucellosis. Computerized axial tomography (CAT) scanning revealed vertebral-arch destruction in three cases of spondylolisthesis. Circumferential sclerosis of the vertebral bodies was another CAT-scan finding.
The reproducibility and sensitivity of quantitative infra-red thermography as a measure of peripheral joint inflammation was reassessed. Experiments were carried out in a temperature-controlled room at 20 degrees C. Initial stabilization experiments showed that in normal, medium sized, joints, there was an initial rapid cooling phase followed by a slower cooling phase which lasted longer than two hours. In the knees the differences between normal and active rheumatoid joints increased the longer patients remained in the room but for practical reasons a 30-minute stabilization period was subsequently chosen. In views of hands and fingers, rebound increases in skin temperature after entering the room, together with lesser differences between inflamed and non-inflamed joints, were found. The results suggested that the thermographic technique examined was adequate for detecting inflammatory changes in knee, ankles and elbows but unsatisfactory for quantification of inflammation in the small joints of the hands.
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