Hematogenous Pyogenic Facet Joint Infection

Muffoletto, Anthony J.; Ketonen, Leena; Mader, Jon T.; Crow, Wayne N.; Hadjipavlou, Alexander

doi:10.1097/00007632-200107150-00014

Cited by 106 publications

(143 citation statements)

References 30 publications

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“…Notre série ne se distingue pas par rapport aux données issues de la littérature qui révèlent 54 cas d'arthrites septiques dont 47 documentés bactériologiquement : 33 Staphylocoques aureus (70 %), sept streptocoques (16 %), trois BGN (7 %), un Enterococcus faecalis (1 %), un parvovirus B19 (1 %) et deux prélève-ments multigermes (4 %) [1,5,7,8,10,11,[13][14][15]20,24,31]. Les germes les plus fréquemment retrouvés sont [13] Staphylococcus aureus (82 %), Steptococcus species (6 %), Enterococcus faecalis (3 %), bacilles Gram négatifs (6 %). À noter qu'aucun cas d'atteinte tuberculeuse, mycologique ou parasytaire n'a été décrit, probablement faute de recherche spécifique.…”

Section: Discussionunclassified

Une forme particulière d’arthrite septique : l’arthrite septique inter-apophysaire postérieure

Michel-Batôt

Dintinger

Blum

et al. 2008

Revue du Rhumatisme

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Section: Discussionunclassified

Une forme particulière d’arthrite septique : l’arthrite septique inter-apophysaire postérieure

Michel-Batôt

Dintinger

Blum

et al. 2008

Revue du Rhumatisme

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“…[32][33][34][35] This is another important route of infection resulting in epidural/ paraspinal abscesses. Facet joint infection is often haematogenous but also caused by epidural anaesthesia and spinal procedures.…”

Section: Epidural/paraspinal Abscess With Facet Joint Infectionmentioning

confidence: 99%

Pyogenic and non-pyogenic spinal infections: emphasis on diffusion-weighted imaging for the detection of abscesses and pus collections

Moritani

Kim²,

Capizzano³

et al. 2014

BJR

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The incidence of spinal infections has increased in the past two decades, owing to the increasing number of elderly patients, immunocompromised conditions, spinal surgery and instrumentation, vascular access and intravenous drug use. Conventional MRI is the gold standard for diagnostic imaging; however, there are still a significant number of misdiagnosed cases. Diffusion-weighted imaging (DWI) with a b-value of 1000 and apparent diffusion coefficient (ADC) maps provide early and accurate detection of abscess and pus collection. Pyogenic infections are classified into four types of extension based on MRI and DWI findings: (1) epidural/paraspinal abscess with spondylodiscitis, (2) epidural/ paraspinal abscess with facet joint infection, (3) epidural/paraspinal abscess without concomitant spondylodiscitis or facet joint infection and (4) intradural abscess (subdural abscess, purulent meningitis and spinal cord abscess). DWI easily detects abscesses and demonstrates the extension, multiplicity and remote disseminated infection. DWI is often a key image in the differential diagnosis. Important differential diagnoses include epidural, subdural or subarachnoid haemorrhage, cerebrospinal fluid leak, disc herniation, synovial cyst, granulation tissue, intra-or extradural tumour and post-surgical fluid collections. DWI and the ADC values are affected by susceptibility artefacts, incomplete fat suppression and volume-averaging artefacts. Recognition of artefacts is essential when interpreting DWI of spinal and paraspinal infections. DWI is not only useful for the diagnosis but also for the treatment planning of pyogenic and nonpyogenic spinal infections.Spinal and paraspinal infections include vertebral osteomyelitis, spondylodiscitis, infectious facet arthropathy, epidural infections, meningitis, myelitis and infections of paraspinal soft tissue and musculature. Evidence of spinal infections has been discovered in the remains of prehistoric humans from 7000 BC. 1 The incidence has increased in the past two decades, owing to the rising number of elderly patients, immunocompromised conditions, spinal surgery and instrumentation, vascular access and intravenous drug use.1-4 Despite advances in medical knowledge, imaging modalities and surgical interventions, the diagnosis of this entity is still challenging since the clinical features can be subtle and misleading. MRI including post-contrast studies is the gold standard for diagnostic imaging. However, although MRI has relatively high diagnostic sensitivity, specificity and accuracy, there are still a significant number of challenging cases. In such cases, diagnostic delays and suboptimal management can result in irreversible paralysis, critical sepsis and even death.Diffusion-weighted imaging (DWI) has proven to be a useful tool for the diagnosis of a variety of intracranial infections especially in the detection of brain abscesses and pus collections, which encompass subdural and epidural empyema, purulent meningitis and ventriculitis. [5][6][7][8] Therefore, DWI ...

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“…Septic arthritis of a lumbar facet joint is also an uncommon entity, with most cases reported in the lumbar region, especially on the L4-L5 facet joints [24]. Septic arthritis of the facet joint may complicate with joint destruction, facet dislocation, bony ankylosis, paraspinal abscess or local epidural abscess (Fig.…”

Section: Rare Extension and Distribution Patternmentioning

confidence: 99%

“…Septic arthritis of the facet joint may complicate with joint destruction, facet dislocation, bony ankylosis, paraspinal abscess or local epidural abscess (Fig. 4) [22,24].…”

Section: Rare Extension and Distribution Patternmentioning

confidence: 99%

“…Common MR features of pyogenic [3][4][5][6][7][8][9] and tuberculous [4][5][6][7][8][9][10][11][12] spinal infections have been extensively described. However, the occasionally atypical MR appearance of spinal infection may be particularly misleading [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. The potential of various degenerative and inflammatory entities for clinically and radiologically resembling spinal infection should also be acknowledged [29][30][31][32].…”

Section: Introductionmentioning

confidence: 99%

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MR imaging of spinal infection: atypical features, interpretative pitfalls and potential mimickers

et al. 2004

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The wide variability of MR features in spinal infection reflects rare distribution of discovertebral involvement, unexpected soft-tissue and bone abnormalities, un-usual complications or uncommon pathogens. In addition, several de-generative and inflammatory entities can clinically and radiologically resemble spinal infection. In this pictorial review, we illustrate the various atypical features that may be found in MR imaging of spinal infection,with emphasis on interpretative pit-falls and common mimickers.

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Hematogenous Pyogenic Facet Joint Infection

Cited by 106 publications

References 30 publications

Une forme particulière d’arthrite septique : l’arthrite septique inter-apophysaire postérieure

Une forme particulière d’arthrite septique : l’arthrite septique inter-apophysaire postérieure

Pyogenic and non-pyogenic spinal infections: emphasis on diffusion-weighted imaging for the detection of abscesses and pus collections

MR imaging of spinal infection: atypical features, interpretative pitfalls and potential mimickers

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