MR imaging of tuberculous vertebral osteomyelitis: pictorial review

Gouliamos, A.; Kehagias, Dimitrios; Lahanis, Stephanos; Athanassopoulou, Alexandra A.; Moulopoulou, E S; Kalovidouris, A.; Trakadas, S.; Vlahos, Lambros

doi:10.1007/s003300000631

Cited by 63 publications

(28 citation statements)

References 9 publications

(15 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The scarcity of proteolytic enzymes, which is an intrinsic characteristic of Mycobacterium tuberculosis, results in a remarkably late, indolent infection of the intervertebral disc (21) . Thus, tuberculous spondylodiscitis may originate large paravertebral abscesses or granulomatous masses with well defined borders (17) , extending into the subligamentous space through several (typically more than three) vertebral bodies at the time of the imaging diagnosis.…”

Section: Tuberculous Spondylodiscitismentioning

confidence: 99%

Pyogenic and tuberculous discitis: magnetic resonance imaging findings for differential diagnosis

et al. 2013

View full text Add to dashboard Cite

Spondylodiscitis represents 2%-4% of all bone infections cases. The correct diagnosis and appropriate treatment can prevent complications such as vertebral collapse and spinal cord compression, avoiding surgical procedures. The diagnosis is based on characteristic clinical and radiographic findings and confirmed by blood culture and biopsy of the disc or the vertebra. The present study was developed with Clementino Fraga Filho University Hospital patients with histopathologically and microbiologically confirmed diagnosis of spondylodiscitis, submitted to magnetic resonance imaging of the affected regions. In most cases, pyogenic spondylodiscitis affects the lumbar spine. The following findings are suggestive of the diagnosis: segmental involvement; ill-defined abscesses; early intervertebral disc involvement; homogeneous vertebral bodies and intervertebral discs involvement. Tuberculous spondylodiscitis affects preferentially the thoracic spine. Most suggestive signs include: presence of well-defined and thin-walled abscess; multisegmental, subligamentous involvement; heterogeneous involvement of vertebral bodies; and relative sparing of intervertebral discs. The present pictorial essay is aimed at showing the main magnetic resonance imaging findings of pyogenic and tuberculous discitis. Keywords: Magnetic resonance imaging; Discitis; Intervertebral disc; Spinal tuberculosis.Espondilodiscites representam 2%-4% de todos os casos de infecções no esqueleto. Seu rápido diagnóstico e tratamento apropriado podem evitar complicações, tais como colapsos vertebrais, compressão medular, evitando a realização de procedimentos cirúrgicos. Seu diagnóstico é baseado em achados clínicos e radiológicos característicos, sendo confirmado por hemoculturas, biópsia do disco ou da vértebra. Este estudo foi realizado com pacientes do Hospital Universitário Clementino Fraga Filho que tiveram o diagnóstico histopatológico ou microbiológico comprovado de espondilodiscite e realizaram ressonância magnética das regiões acometidas. Espondilodiscites piogênicas acometem preferencialmente a coluna lombar. Os principais sinais sugestivos são: acometimento segmentar; abscessos de limites pouco definidos; acometimento precoce do disco intervertebral; acometimento homogêneo dos corpos vertebrais e discos intervertebrais. A espondilodiscite tuberculosa afeta preferencialmente os segmentos vertebrais torácicos. As imagens mais sugestivas são: abscesso de paredes delgadas e bem definidas; envolvimento subligamentar multissegmentar; acometimento heterogêneo dos corpos vertebrais; discos intervertebrais relativamente poupados. O objetivo deste ensaio iconográfico é apresentar os principais aspectos das espondilodiscites piogênica e tuberculosa nas imagens por ressonância magnética. Unitermos: Ressonância magnética; Discite; Disco intervertebral; Tuberculose da coluna vertebral. AbstractResumo * Study developed in the

show abstract

Section: Tuberculous Spondylodiscitismentioning

confidence: 99%

Pyogenic and tuberculous discitis: magnetic resonance imaging findings for differential diagnosis

et al. 2013

View full text Add to dashboard Cite

show abstract

“…The hematogenous spread from a primary or reactivated focus in another body part is the key to the behavior of the infection in the musculoskeletal system [1,2,3,4].…”

Section: Pathogenesis and Its Consequencesmentioning

confidence: 99%

“…Direct involvement from a contiguous paraspinal site is rare [4]. Retrograde venous spread through the Batson's plexus, which runs subchondrally in the vertebral body and drains the blood of the basivertebral vein in center of the vertebral body, has been proposed [5], but it seems to be very unlikely [6,7].…”

Section: Tuberculous Spondylitismentioning

confidence: 99%

Imaging features of musculoskeletal tuberculosis

et al. 2003

View full text Add to dashboard Cite

The purpose of this article is to review the imaging characteristics of musculoskeletal tuberculosis. Skeletal tuberculosis represents one-third of all cases of tuberculosis occurring in extrapulmonary sites. Hematogenous spread from a distant focus elsewhere in the body is the cornerstone in the understanding of imaging features of musculoskeletal tuberculosis. The most common presentations are tuberculous spondylitis, arthritis, osteomyelitis, and soft tissue involvement. The diagnostic value of the different imaging techniques, which include conventional radiography, CT, and MR imaging, are emphasized. Whereas conventional radiography is the mainstay in the diagnosis of tuberculous arthritis and osteomyelitis, MR imaging may detect associated bone marrow and soft tissue abnormalities. MR imaging is generally accepted as the imaging modality of choice for diagnosis, demonstration of the extent of the disease of tuberculous spondylitis, and soft tissue tuberculosis. Moreover, it may be very helpful in the differential diagnosis with pyogenic spondylodiscitis, as it may easily demonstrate anterior corner destruction, the relative preservation of the intervertebral disk, multilevel involvement with or without skip lesions, and a large soft tissue abscess, as these are all arguments in favor of a tuberculous spondylitis. On the other hand, CT is still superior in the demonstration of calcifications, which are found in chronic tuberculous abscesses.

show abstract

“…Tuberculosis occurs most commonly in the thoracic spine, particularly at the thoracolumbar junction. Relative preservation of the intervertebral disk and subligamentous spread beneath the anterior longitudinal ligament, extending more than three vertebral segments, has been attributed to the lack of proteolytic enzymes in mycobacterial infections (Gouliamos et al 2001 ;Jung et al 2004 ;Diehn 2012 ). Some studies have shown that more than 50 % of cases have only isolated vertebral involvement with sparing of the disk space (Pertuiset et al 1999 ).…”

Section: Pyogenic Versus Tuberculous Spondylitismentioning

confidence: 99%