Nsɛm a Wɔaboaboa Ano a Ɛfa Akyi berɛmo mu Nyarewa Ahorow Su Ho

Akyi berɛmo mu yareɛ yɛ 2% kɔsi 7% wɔ ntini ne nnompe mu nyarewa a mmoawa, fungi, ne, ɛntaa nsi no, mmoawa a wɔsɛe nnɔbae na ɛde ba nyinaa mu. Nnipa a wɔanya akyi berɛmo mu yare nyinaa mu bɛyɛ fã wɔ akyi berɛmo mu, ɛboro nkyem abiɛsa mu biako kakra wɔ ahurututu mu, na nea aka no wɔ awotwaa mu akyi berɛmo mu.

Purulent Infection a Ɛma Nnipa Yɛ Fɛ

Mpɛn pii no, ɔyare mmoawa a ɛtrɛw fi mogya mu na ɛde akyi berɛmo mu yare a ɛyɛ puru (PS) ba, na Staphylococcus aureus ne ɔyare mmoawa a ɛtaa ba, na ɛtaa fa akyi berɛmo no ho, na x-ray ahorow no nni pɔtee ne nkate biara wɔ yare no mfiase. MRI a wɔama anya nkɔso ne ɔkwan a wɔpaw de hu akyi berɛmo mu nyarewa ntɛm; MRI kyerɛ nnompe mu ntini a ɛyɛ mmerɛw na ɛma akyi berɛmo nipadua, akyi berɛmo ntam ntini, epidural space, ne/anaasɛ ntini a ɛyɛ mmerɛw a atwa ho ahyia a akisikuru ayɛ anaasɛ enni mu a ɛbɛn akyi berɛmo no awiei titiriw no mu nkɔso.

Hyɛ no nsow: (a) Lateral lumbar spine radiograph a ɛkyerɛ L4 -L3 disc no sorokɔ a ɛyera ne L4 atifi awiei no sɛe (agyan). 

(b) Akyi a ɛyɛ mmerɛw wɔ L3. ɔsɛe a ɛba L3 - L4 diski no mu a nsakrae a ɛyɛ hu ba awiei mprɛte a ɛbɛn hɔ no so (agyan). 

(c) Magnetic resonance (MR) mfonini a ɛkyerɛ nsakrae a ɛyɛ erosive wɔ vertebral endplates ne sɛnkyerɛnne a ɛnteɛ a ɛwɔ vertebral bone marrow a ɛbɛn hɔ no mu (agyan). Ntini a ɛyɛ mmerɛw a ɛwɔ akyi berɛmo no anim no yɛ nea ɛho ayɛ kurukuruwa kɛse na ɛwɔ nsakrae a ɛma ɔfe. 

(d) Sagittal t1 wɔ ntini mu nsonsonoe injection akyi no kyerɛ sɛnkyerɛnne a ɛkɔ soro wɔ nnompe mu ntini mu (nsoromma), sɛnkyerɛnne a ɛkɔ soro wɔ epidural space ne prevertebral soft tissue. Hyɛ sɛnea mfinimfini nsuten (agyan) no akɔ mu no nsow.

Akyi berɛmo mu Nsanyare

Tuberculosis of the spine (TS), akyi berɛmo mu yareɛ a ɛnyɛ purulent granulomatous a ɛtaa ba a Gram-positive Mycobacterium tuberculosis de ba, ne mfoniniyɛ mu nneɛma a ɛma TS da nsow wɔ PS ntam no wɔakyerɛ wɔ pon a ɛwɔ aseɛ ha yi mu:

Radiographs a wɔde twaa akyiri yi kyerɛ nnompe a ɛsɛe, disc tenten a ɛso tew ne ntini a ɛyɛ mmerɛw a ɛyɛ mmerɛw a ɛwɔ ntini a ɛyɛ mmerɛw a atwa ho ahyia no mu calcification anaasɛ enni mu.

Wɔ MRI so no, t1 a ɛtaa de nsɛnkyerɛnne a ɛba fam ne nsɛnkyerɛnne a ɛkɔ soro a ɛwɔ nsu a ɛyɛ mmerɛw a ɛtoatoa so no fa anim akyi berɛmo nipadua no ho na ebetumi atrɛw afa subgamentous kwan no so akɔ akyi berɛmo afoforo mu, mpɛn pii no ɛnyɛ nea ɛfa diski no ho.

Nsɛm a ɛsɛ sɛ yɛhyɛ no nsow: Ɔbarima a wadi mfe 65 a ɔwɔ (a) axial ne (b) lumbar abscesses (asterisk) a septal ne wall enhancement (agyan fitaa).L3 kosi S1 vertebral body enhancement. Intervertebral disc a abubu a ennya nkɔso kɛse biara. Dural sac compression (agyan fitaa). (c) ct reconstruction mfonini a ɛkyerɛ L3 kosi S1 akyi berɛmo nipadua a wɔsɛe no.

Brucella Nyarewa a Wɔde Yɛ Adwuma

Brucellosis yɛ mmoa mu yare a ɛwɔ wiase nyinaa a gram-negative bacillus na ɛde ba. Ɛtaa fa akyi berɛmo no ho, titiriw L4.

Yare no fi ase wɔ akyi berɛmo nipadua no fã a ɛwɔ akyi berɛmo ntam diski no mu na ebetumi asɛe nkwaa nketewa. Paravertebral abscesses ntaa mma na ne kɛse sua sen TS. Akyi berɛmo no nipadua no da so ara yɛ nea ɛte saa.

Hyɛ no nsow: Brucella lumborum yare mmoawa, radiographs kyerɛ sɛ akyi berɛmo no mu ntini a ɛyɛ mmerɛw, akyi berɛmo no a ɛtwetwe kɔ anim, ɔsɛe a ɛte sɛ anammɔn a ɛnkɔ so daa wɔ akyi berɛmo nipadua no anim, ne nnompe cribriforms a ɛba akyi berɛmo nipadua no anim.

Fungal Nyarewa a Wɔde Ma

Fungal spinal infections (FS) ho yɛ na na wɔtaa hu wɔ ayarefo a wɔn nipadua no tumi ko tia nyarewa no mu. Nwansena pii betumi aka ho, a Pseudomonas, Aspergillus, Bacillus, ne Coccidioides ka ho. Akyi berɛmo no ne beae a ɛtaa ba, na te sɛ TS no, ɔyare mmoawa no fi ase wɔ akyi berɛmo no anim fã na ɛtɔ mmere bi a ebetumi atrɛw akɔ akyi berɛmo a ɛnyɛ nea ɛbɛn hɔ mu.

Hyɛ no nsow: CT scan sagittal mfonini a ɛkyerɛ ɔyarefo bi a ɔwɔ coccidioidomycosis. Nnompe mu akuru kakraa bi a enni sclerotic margins yɛ ɔyare mmoawa yi su wɔ nkyerɛkyerɛmu no mu. T1 a wɔsɛe no kɛse no ma akyi berɛmo no hwe ase. Ɛmfa ho sɛ na nnompe mu akuru no trɛw no, wɔkoraa C7-T1 akyi berɛmo ntam ahunmu no so, nsakrae a ɛda nsow wɔ coccidioidomycosis (nifa so panel) Sagittal MRT2WI a ɔyarefo koro no ara wɔ no si so dua sɛ wɔakora C7-T1 akyi berɛmo ntam ahunmu ɔsram no so, a T2 sɛnkyerɛnne titiriw bi kyerɛ sɛ C6-C7 diski ahorow no de ne ho ahyɛ mu ntɛm. Nnompe no akuru no trɛw kɔɔ subcortical bone a ɛwɔ akyi berɛmo nipadua no anim no mu, na ɛde anim ntini a ɛyɛ mmerɛw no yare IV bae. Nsakrae a ɛde ɔyare mmoawa ba no trɛw kɔɔ mmeae pii, na ɛnyɛ den sɛ wobehu ɔkwan a subgamentous type no fa so trɛw, a ebetumi ama akuru pii aba wɔ mmeae a ɛnyɛ nea ɛbɛn ho.

Ankylosing Spondylitis a Ɛyɛ Akisikuru

Ankylosing spondylitis (AS) yɛ yare a enni sabea a ɛma nipadua no tumi ko tia nipadua no a ɛka akyi berɛmo no titiriw na ebetumi ama obi ate ɛyaw a enni sabea kɛse esiane akyi berɛmo a ɛka bom nti.

Ɔhaw foforo a ɛwɔ ayarefo a wɔwɔ AS mu ne diski yare a anohyeto wom a ɛba, na wɔ mfoninitwa mu no, wobetumi ahu nsonsonoe a ɛda AL ntam wɔ ahurututu mu yare a ɛma obi ho hyehye no ho denam sintɔ ahorow a ɛwɔ akyi berɛmo biako anaa abien a ɛbɛn ho mu, diski no mu baabi a ɛyɛ teateaa, ne mmeae a ɛyɛ adwuma a ɛyɛ mmerɛw a atwa nnompe mu sintɔ ahorow no ho ahyia no so.

Hyɛ no nsow: Ɔyarefo a ɔwɔ ankylosing spondylitis, ɔbarima a wadi mfe 44 a n’akyi yɛ no yaw a enni sabea na ontumi nkɔ baabiara. Sagittal ct a ɛwɔ (a) thoracic ne (b) lumbar spine bone windows mu no kyerɛ diffuse ligamentous syndesmosis wɔ anterior longitudinal ligament no so (agyan). Afei nso, nnompe a ɛyɛ nnompe ne akyi berɛmo ntam ntini a ɛka bom wɔ hɔ (wɔakyerɛ agyan). (c) Coronal mfonini a ɛwɔ akyi berɛmo gyinabea no kyerɛ sɛ akyi nneɛma ne articular synovial joints (agyan) no afrafra.

Nnompe mu Yare a Ɛyare

Asɛmfua tiawa SAPHO kyerɛ ntini ne honam ani nsɛnkyerɛnne a wɔaka abom (synovitis, acne, pustulosis, osteomalacia, ne osteomyelitis), a ahurututu fasu a ɛwɔ anim (a sternoclavicular nkwaa, costothoracic nkwaa, ne sternoacetabular elbow nkwaa ka ho) na ɛtaa ka ho, na ɛno akyi no, akyi berɛmo ne cervical spine.Nneɛma a ɛtaa da adi wɔ x-ray radiographs so ne vertebral body osteolysis a ɛwɔ collapse anaasɛ enni mu, ne osteomalacia ne paraspinal ossification.MRI ne mfoninitwa a ɛyɛ mmerɛw sen biara MRI ne mfoninitwa kwan a ɛyɛ mmerɛw sen biara, na nea ɛda adi titiriw no bi ne nsakrae a ɛtrɛw anaasɛ ɛkɔ so wɔ akyi berɛmo mu sɛnkyerɛnne a ɛba nnidiso nnidiso a ɛyɛ mmerɛw a cortical erosion ne irregularities wɔ akyi berɛmo ntam nkitahodi a ɛwɔ akyi berɛmo ntam diski anaa anim awiei, ne ntini a ɛyɛ mmerɛw a ɛyɛ mmerɛw.

Hyɛ no nsow: Ɔbarima a wadi mfe 62 a ɔwɔ SAPHO yare no. (a) Sagittal t2-weighted ne (b) computed tomography (CT) mfonini ahorow kyerɛ sɛ anim longitudinal ligament no nnompe ayɛ (agyan tuntum) Diski anaa paravertebral nsu no mu nsakrae titiriw biara nni hɔ. Wɔsan de L1 no si hɔ kɛse wɔ compression fracture dedaw bi akyi. (c) Axial CT kyerɛ sɛ ankylosis wɔ costovertebral nkwaa nifa so (nsoromma). (d) Oblique coronal CT reconstruction kyerɛ afã abien thoracic ribcage clavicle ankylosis (nsoromma tuntum). (e) Nnompe mu nhwehwɛmu a ɛkyerɛ sɛnea radiotracer fa wɔ nkwaa abien a ɛkaa no abien no nyinaa mu (nsoromma fitaa).

Spondyloarthropathy a ɛfa dialysis ho

Dialysis-related spondyloarthropathy (DRS) yɛ ɔyare mu nsakrae a ɛba ayarefo a wɔde bere tenten yɛ hemodialysis no mu. Ɛtaa ba awotwaa no akyi berɛmo mu na ɛtaa ba bere a akyi berɛmo no ntam kwan no yɛ teateaa, awiei no sɛe, sclerosis a enni hɔ, nnompe foforo a ɛba, paraspinal infections/abscesses, ne ahunmu no mu den.

Hyɛ no nsow: Nnompe mu yare kɛse a ɛba akyi berɛmo ne akyi berɛmo mu. Akisikuru 5 akyi berɛmo no anterosuperior margin a wɔsɛe no a sclerotic hyperplasia wɔ anoano (wɔde agyan kɔkɔɔ no kyerɛ). Akuru a ɛbɛn ho hyperplasia. Benkum so sacroiliac nkwaa a wɔsɛe no ne ilium no akyi ntini no ani a wɔsɛe no, nnompe a awuwu pii a ɛwɔ mu, ne ntini a ɛte sɛ akuru a ɛwɔ mpɔtam hɔ a ɛyɛ kɛse (wɔde agyan bruu akyerɛ).

Hyɛ no nsow: MR a wɔama anya nkɔso: Lumbar 4/5 disc bulge with vertebral rim osteophytes, ligamentum flavum a ɛyɛ kɛse dodo, akyi berɛmo no kwan a ɛyɛ teateaa kakra, ne dural kotoku no anim ano a ɛhyɛ. Lumbar 5 vertebral nipadua no yɛ nea ɛyɛ concave kakraa bi na wobetumi ahu sɛ strips of long T1 ne T2 WI compression fat high signal, na wohu nkɔso wɔ enhancement akyi. Wohu sɛnkyerɛnne a ɛnyɛ ne kwan so mmeae pii wɔ akyi berɛmo 5 ne sacral 1 awiei ne sacroiliac nkwaa ase, na sɛnkyerɛnne a ɛba fam wɔ T1WI so na sɛnkyerɛnne a ɛkorɔn kakra wɔ T2WI so, na wohu nkɔso wɔ enhancement scans (agyan kɔkɔɔ). Wohuu ntini a ɛyɛ mmerɛw a ɛyɛ den wɔ sacral vertebrae no anim ano, na wohuu nkɔso wɔ enhanced scan (agyan bruu) so. Nnompe mu nsɛnkyerɛnne a ɛwɔ ilium, asen, sacrum ne asen ti a ɛwɔ akyi berɛmo no afã abien no nyinaa ankyerɛ sɛ ɛnyɛ ne kwan so a ɛda adi pefee, na na nsɛnkyerɛnne a ɛwɔ akyi berɛmo mu ntini a ɛwɔ mu ne akyi no yɛ nea ɛfata, na ntini mu nsonsonoe a emu da hɔ ne nkwaa mu nsonsonoe a ɛfata, a na sɛnkyerɛnne biara nni ho sɛ ɛretrɛw na ayɛ teateaa.

Akyi berɛmo mu Gout

Akyi berɛmo mu gout yɛ nea ɛda adi sɛ monocrystalline urate crystals (MUCs) a ɛwɔ akyi berɛmo no mu. Akyi berɛmo mu gout ka akyi berɛmo no titiriw. radiographs kyerɛ nneɛma a ɛnyɛ pɔtee na CT da nnompe a ɛporɔw a ɛwɔ sclerotic margins no adi yiye. mri a ɛda adi no nyɛ nea ɛyɛ pɔtee.

Hyɛ no nsow: CT plain scan kyerɛ nkwaa no mu baabi a ɛyɛ teateaa na ntini no ani a ɛwɔ afã abien no sɛe. Ɛsɛ sɛ wɔyɛ arthrocentesis na ama wɔahu sɛ obi anya yare no.

Ntini mu ntini mu yare

Neurogenic spondylitis (NS), ntini mu yare a ɛkɔ so sɛe ade, ba bere a obi ahwere nkate ne ne ho a ɔte nka akyi. Nea ɛtaa de ba ne akyi berɛmo mu opira a ɛyɛ hu, a ɛyɛ nsɛm no mu 70%. Nneɛma afoforo a ɛde ba ne asikreyare, akyi berɛmo mu amena mu yare, ne ntini mu yare afoforo te sɛ peroneal muscular dystrophy ne Guillain-Barré syndrome. Esiane dwuma a thoracolumbar ne lumbosacral junctions di wɔ mu duru a wɔsoa mu nti, ɛno ne mmeae a ɛtaa ka ho.

Nneɛma a ɛtaa da NS adi ne nnompe asinasin, akyi berɛmo ntam nkwaa a ɛnkɔ so pɛpɛɛpɛ ne nea ɛnhyia a ɛde akyi berɛmo nipadua no hwirew, awiei mprɛte pii ne nkwaa nketenkete a ɛporɔw ne nnompe a ɛyɛ den a wɔkora so wɔ sclerosis mu, ne ntini a ɛyɛ mmerɛw nso.

Hyɛ no nsow: Ɔbarima a wadi mfe 58 a ɔwɔ akyi berɛmo mu yare. (a) Sagittal ne (b) coronal computed tomographic reconstructions kyerɛ lumbar vertebral endplates pii ne articular synovial joint erosions (agyan) a nnompe asinasin wom. L2-L3 intervertebral disc unit no a wɔsɛe no a intervertebral space no trɛw (nsoromma). (c) Sagittal ne (d) axial t2-weighted magnetic resonance sequences a ɛkyerɛ sɛ L2-L3 intervertebral space no atrɛw. nsakrae titiriw a ɛba akyi berɛmo a ɛka L2-L3-L4 akyi no mu. Effusion nso wɔ ntini a ɛyɛ mmerɛw a ɛwɔ akyi ne anim wɔ akyi berɛmo mu nneɛma (nsoromma) no mu.