The Diagnostic Value of MRI in Brucella Spondylitis With Comparison to Clinical and Laboratory Findings

Bagheri, Ali; Ahmadi, Koorosh; Chokan, Niaz Mohamad Jafari; Abbasi, Bita; Akhavan, Reza; Bolvardi, Ehsan; Soroureddin, Somayeh

doi:10.5455/aim.2016.24.107-110

Cited by 13 publications

(12 citation statements)

References 15 publications

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“…Epidural abscess is a rare complication of spondylitis and its diagnosis is difficult due to non-specific symptoms. Among the serological tests and radiological techniques, MRI is the most valuable method to diagnose spinal brucellosis or spinal epidural abscess[34,35]. MRI is also helpful to differentiate between pyogenic spondylitis and brucellar spondylitis[36].…”

Section: Osteoarticular Manifestationsmentioning

confidence: 99%

Osteoarticular manifestations of human brucellosis: A review

Esmaeilnejad-Ganji

2019

WJO

110

109

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Brucellosis is a common global zoonotic disease, which is responsible for a range of clinical manifestations. Fever, sweating and musculoskeletal pains are observed in most patients. The most frequent complication of brucellosis is osteoarticular involvement, with 10% to 85% of patients affected. The sacroiliac (up to 80%) and spinal joints (up to 54%) are the most common affected sites. Spondylitis and spondylodiscitis are the most frequent complications of brucellar spinal involvement. Peripheral arthritis, osteomyelitis, discitis, bursitis and tenosynovitis are other osteoarticular manifestations, but with a lower prevalence. Spinal brucellosis has two forms: focal and diffuse. Epidural abscess is a rare complication of spinal brucellosis but can lead to permanent neurological deficits or even death if not treated promptly. Spondylodiscitis is the most severe form of osteoarticular involvement by brucellosis, and can have single- or multi-focal involvement. Early and appropriate diagnosis and treatment of the disease is important in order to have a successful management of the patients with osteoarticular brucellosis. Brucellosis should be considered as a differential diagnosis for sciatic and back pain, especially in endemic regions. Patients with septic arthritis living in endemic areas also need to be evaluated in terms of brucellosis. Physical examination, laboratory tests and imaging techniques are needed to diagnose the disease. Radiography, computed tomography, magnetic resonance imaging (MRI) and bone scintigraphy are imaging techniques for the diagnosis of osteoarticular brucellosis. MRI is helpful to differentiate between pyogenic spondylitis and brucellar spondylitis. Drug medications (antibiotics) and surgery are the only two options for the treatment and cure of osteoarticular brucellosis.

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Section: Osteoarticular Manifestationsmentioning

confidence: 99%

Osteoarticular manifestations of human brucellosis: A review

Esmaeilnejad-Ganji

2019

WJO

110

109

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“…According to the data, MRI is the diagnostic method of choice for brucellosis-induced spondylitis (35,36). In the current study, the diagnosis was achieved by MRI and bone scan for 31 and one patients, respectively.…”

Section: Discussionmentioning

confidence: 91%

Brucellar Spondylitis in Kermanshah as an Endemic Area in West of Iran

Sayad

Mohamadi

Shirvani

et al. 2019

Arch Clin Infect Dis

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Background: Spondylitis is an important osteoarticular manifestation of brucellosis that leads to serious complications. Objectives: We aimed to investigate various aspects of spondylitis in brucellosis patients in Kermanshah, a highly endemic area in the West of Iran. Methods: This retrospective, single-center, cross-sectional study investigated 289 brucellosis patients among whom, 32 patients were confirmed to have brucellar spondylitis. The diagnosis of brucellosis was made by Wright or Coombs Wright tests (titers ≥ 1/80) or 2ME test (titer ≥ 1/40). Brucellar spondylitis was confirmed by vertebral MRI or whole-body bone scan. All analyses were done using SPSS 21 software. The chi-square or Fisher exact test was used for assessing associations. P values of < 0.05 were considered statistically significant.Results: Among 289 patients studied, 32 (11.07%) had spondylitis with a mean age of 53.44 ± 16.06 years. Unpasteurized dairy product consumption, rural residence, and livestock-related occupation were reported by 30 (93.7%), 22 (68.7%), and 28 (87.5%) patients, respectively. Back pain (100%) was the most common symptom while the temperature of ≥ 37.7 (50%) and vertebral column tenderness (50%) were the most observed signs. Brucellar spondylitis was statistically related to age > 40 years, admission duration > 10 days, and ESR > 40 mm/h but not to sex, fever, anemia, and Wright titer. The lumbar disc involvement was the most common involvement (90.6%) in brucellar spondylitis patients. Vertebral body involvement, abnormal marrow signal, and bone marrow edema were observed in all 31 patients diagnosed with MRI. Conclusions: Brucellar spondylitis should be considered in patients with lower back pain and fever in endemic areas. Positive Wright serology, vertebral body involvement in MRI, and elevated ESR greatly favor the diagnosis of this complication.

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“…The vertebrae collapse seen in MRI may be the hallmark of spondylitis though patient didn’t complaint of any back pain but he also didn’t report any history of back trauma. Hence, as the patient is young with no morbid conditions, spine involvement by Brucella is the most likely cause of this collapse [15] .…”

Section: Discussionmentioning

confidence: 99%

Brucellosis: A cause of meningitis not to neglect

Lemnouer

Frikh

Maleb

et al. 2017

IDCases

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Brucellosis is the most frequent bacteria zoonosis in the world, with more than half a million new cases each year [1]. It is also the most significant zoonos in the edge of the Mediterranean Sea [2]. This zoonosis is capable of affecting humans and cause polymorphic clinical manifestations. In Morocco, the southern regions are the main affected areas [3].We are reporting the observation of a 17-year-old male patient, who presented a febrile meningeal syndrome for 9 months without sensitivo-motor deficit. Tuberculosis is frequently evoked in such clinical presentations because Morocco is an endemic country, brucellosis is therefore often forgotten. The results of lumbar puncture, magnetic resonance imaging (MRI) and especially serology aided to conclude to a neuro-brucellosis. The outcome was favourable with antibiotic therapy.

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The Diagnostic Value of MRI in Brucella Spondylitis With Comparison to Clinical and Laboratory Findings

Cited by 13 publications

References 15 publications

Osteoarticular manifestations of human brucellosis: A review

Osteoarticular manifestations of human brucellosis: A review

Brucellar Spondylitis in Kermanshah as an Endemic Area in West of Iran

Brucellosis: A cause of meningitis not to neglect

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