Kpuie Kpuie Le Akɔtadɔ Vovovowo Ƒe Nɔnɔmewo Ŋu

Aklãdɔléle nye 2% va ɖo 7% le lãmekawo ƒe dɔléle siwo katã dɔlékuiwo, fungiwo, kple, ƒã wu la, dɔlékuiwo hena vɛ. Aklãdɔlékuiwo katã ƒe afã lɔƒo nɔa akɔta ƒe akɔta, wòwua akpa etɔ̃lia vie le akɔta ƒe akɔta, eye susɔea nɔa vidzidɔ ƒe akɔta.

Dɔlékui si me ʋuʋudedi le

Zi geɖe la, dɔlékui si kaka to ʋumenugbagbeviɣidɔ me gbɔe ʋumenugbagbeviɣidɔ (PS) tsona, eye Staphylococcus aureus ye nye dɔlékui si bɔ wu, zi geɖe la, elɔa akɔta ƒe akɔta, eye x-ray siwo mewɔa dɔ tɔxɛ aɖeke o eye womesea nu gɔme na ame le dɔlélea ƒe gɔmedzedze o. MRI si wodo ŋusẽe nye mɔnu si wozãna tsɔ dea dzesi aklãdɔlékuiwo kaba; MRI ɖea ƒumeŋuɖui ƒe ʋuʋu kple akɔta ƒe ŋutilãwo, akɔtaƒuwo dome diskwo, lãkusi ƒe teƒe, kple/alo lãkusi falɛfalɛ siwo ƒo xlãe siwo me ʋuʋudedi le alo esiwo me ʋuʋudedi mele o siwo te ɖe akɔta ƒe nuwuƒewo ŋu koŋ ƒe dzidziɖedzi fiana.

De dzesii: (a) Lateral lumbar spine radiograph si ɖe L4 -L3 disc ƒe kɔkɔme ƒe bu kple L4 ƒe etame nuwuƒe ƒe tsɔtsrɔ̃ fia (aŋutsrɔe). 

(b) Megbe ƒe ʋuʋu fafɛ le L3. L3 - L4 disk la tsɔtsrɔ̃ kple tɔtrɔ siwo gblẽa nu le nuwuƒe siwo te ɖe eŋu (aŋutsrɔewo). 

(c) Magnetic resonance (MR) nɔnɔmetata si ɖe akɔta ƒe nuwuƒe ƒe tɔtrɔ siwo gblẽa nu le ame ŋu kple akɔtaƒu ƒe ƒu si te ɖe eŋu ƒe dzesi si mesɔ o fia (aŋutsrɔe). Lãmetsi falɛfalɛ siwo le akɔta ƒe akpa si do ŋgɔ na akɔta la tsia dzodzodzoe ŋutɔ eye dɔdzẽ ƒe tɔtrɔwo nɔa wo ŋu. 

(d) Sagittal t1 le ʋuka me vovototodedeameme dodo vɔ megbe ɖea dzesi si dzi ɖe edzi le ƒumeŋuɖui me (ɣletivi), dzesi si dzi ɖe edzi le ƒumeŋuɖui ƒe teƒe kple do ŋgɔ na akɔta ƒe lãkusi falɛfalɛwo me. De dzesi alesi titinatɔdzisasrãa (aŋutsrɔe) ge ɖe emee.

Yɔmekpe si le aklã me

Tuberculosis of the spine (TS), si nye non-purulent granulomatous spinal infection si bɔ wu si Gram-positive Mycobacterium tuberculosis hena vɛ, kple nɔnɔmetatawo ƒe nɔnɔme siwo dea vovototo TS kple PS dome la dze le kplɔ̃ si le ete la dzi:

Radiograf siwo woɖe le megbe la ɖea ƒu ƒe tsɔtsrɔ̃, disk ƒe kɔkɔme dzi ɖeɖe kpɔtɔ kple lãkusi falɛfalɛwo ƒe ʋuʋudedi siwo me kpe falɛfalɛ siwo ƒo xlãe la me kpe le alo esiwo me kpe mele o fiana.

Le MRI me la, t1 ƒe dzesi suewo ƒe sesẽme kple dzesi gãwo ƒe sesẽme si bɔ le tsi-sesẽ ƒe tsiatsia me la lɔ ŋgɔgbe akɔtaƒu ƒe ŋutilã ɖe eme eye ate ŋu akeke to subgamentous mɔa dzi ayi akɔtaƒu bubuwo gbɔ, zi geɖe la, disk la meku ɖe eŋu o.

De dzesii: Ŋutsu si xɔ ƒe 65 si si (a) axial kple (b) lumbar abscesses (ɣletivi) siwo ŋu septal kple wall enhancement le (aŋutsrɔe ɣiwo).L3 vaseɖe S1 vertebral body enhancement. Intervertebral disc si mu eye womekpɔ ŋgɔyiyi ɖedzesi aɖeke o. Dural sac compression (aŋutsrɔe ɣi). (c) ct gbugbɔgatu nɔnɔmetata si nye L3 vaseɖe S1 akɔta ƒe ŋutilã tsɔtsrɔ̃.

Brucella Dɔlékui ƒe Dɔlékui

Brucellosis nye lãwo ƒe dɔléle si bɔ ɖe xexeame katã si gram-negative bacillus hena vɛ. Zi geɖe la, elɔa akɔta ƒe akɔta, vevietɔ L4, ɖe eme.

Dɔlélea dzea egɔme tso akɔtaƒu ƒe akpa si le ŋgɔgbe le akɔtaƒuwo dome eye ate ŋu agblẽ nu le ƒunukpeƒe suewo ŋu. Paravertebral abscesses medzɔna edziedzi o eye woƒe lolome le sue wu TS. Akɔta ƒe ŋutilã ƒe wɔwɔme gakpɔtɔ le nenema.

De dzesii: Brucella lumborum dɔlékui, fotoɖeɖe ɖee fia be akɔta ƒe akɔta ƒe ʋuʋu, akɔta ƒe akɔta ƒe ʋuʋu yi ŋgɔ, tsɔtsrɔ̃ si mesɔ o abe afɔɖeɖe ene le akɔta ƒe ŋutilã ƒe ŋgɔgbekpa dzi, kple ƒu ƒe ƒuƒu ƒe wɔwɔme le akɔta ƒe ŋutilã ƒe ŋgɔgbekpa dzi.

Fungal Dɔlékuiwo

Fungal spinal infections (FS) mebɔ o eye wokpɔnɛ zi geɖe le dɔnɔ siwo ƒe dɔlélenutsiŋutete mesẽ o ŋu. Fungi geɖe ate ŋu akpɔ gome le eme, siwo dometɔ aɖewoe nye Pseudomonas, Aspergillus, Bacillus, kple Coccidioides. Akɔta ƒe akɔtae nye teƒe si bɔ wu, eye abe alesi wòle le TS gome ene la, dɔlélea dzea egɔme tso akɔta ƒe akpa si le ŋgɔgbe eye ate ŋu akaka ɖe akɔta siwo mete ɖe wo nɔewo ŋu o me ɣeaɖewoɣi.

De dzesii: Dɔnɔ aɖe si ŋu coccidioidomycosis le ƒe sagittal nɔnɔmetata si woɖe. Ƒu ƒe abi siwo seɖoƒe li na siwo me sclerotic margins mele o nye dɔlékui sia ƒe dzesi le eɖeɖefia me. T1 ƒe tsɔtsrɔ̃ geɖe hea akɔta ƒe gbagbã vɛ. Togbɔ be ƒu ƒe abi lolo hã la, wokpɔ C7-T1 ƒe akɔta dome teƒea ta, tɔtrɔ si ɖe dzesi le coccidioidomycosis (ɖusime akpa) Sagittal MRT2WI si le dɔnɔ ma ke ŋu ɖo kpe C7-T1 ƒe akɔta dome teƒe ɣleti la takpɔkpɔ dzi, kple T2 ƒe dzesi ɖedzesi aɖe si fia be C6-C7 ƒe diskwo kpɔ gome le eme kaba. Ƒu ƒe abi la keke ta ɖo ƒu si le ƒu ƒe akpa si le ŋgɔgbe na akɔta ƒe ŋutilã me, si na be lãmeka falɛfalɛwo ƒe dɔléle le ŋgɔgbe IV. Dɔlékui ƒe tɔtrɔwo kaka ɖe agbɔsɔsɔ vovovowo me, si wɔnɛ be woate ŋu ade dzesi alesi subgamentous ƒomevi la kakana bɔbɔe, si ate ŋu ana abi geɖe nadze le agbɔsɔsɔ siwo mete ɖe wo nɔewo ŋu o me.

Ankylosing Spondylitis ƒe dɔléle si nye Ankylosing

Ankylosing spondylitis (AS) nye dɔléle si nɔa anyi didi si tsoa dɔlélenutsiŋutete ƒe dɔlélenutsiŋutete gbɔ, si gblẽa nu le aklã ŋu koŋ eye ate ŋu ana ame nase veve vevie atraɖii le aklã ƒe ƒoƒo ɖekae ta.

Kuxi bubu si doa mo ɖa le dɔnɔ siwo ŋu AS le ŋue nye disk ƒe dɔléle si seɖoƒe li na ƒe dzɔdzɔ, eye le nɔnɔmetatawo ɖeɖe me la, woate ŋu ade vovototo AL kple ƒunukpeƒetetedɔ si me dɔdzẽ le dome to nusiwo ŋu woate ŋu akpɔ nu le le akɔtaƒu ɖeka alo eve siwo te ɖe wo nɔewo ŋu me, disk ƒe teƒea ƒe kpuiƒe, kple teƒe siwo ƒumeŋuɖui ƒe dɔléle si nye reactive sclerosis ƒo xlã ƒumeŋuɖui ƒe gbɔdzɔgbɔdzɔwo.

De dzesii: Dɔnɔ si ŋu ankylosing spondylitis le, ŋutsu si xɔ ƒe 44 si ƒe akɔta le veve sem atraɖii eye megate ŋu ʋãna o. Sagittal ct of (a) thoracic kple (b) lumbar spine bone bone windows ɖea diffuse ligamentous syndesmosis fiana le anterior longitudinal ligament (aŋutsrɔewo) ŋu. Ƒumeŋuɖui kple akɔta ƒe lãkusiwo ƒe ƒoƒo ɖekae hã li (woɖe aŋutsrɔewo fia). (c) Coronal image le lumbar spine level ɖea megbenuwo kple articular synovial joints ƒe fusion fiana (aŋutsrɔewo).

Ƒumeŋuɖui ƒe Dɔléle

Kpukpui si nye SAPHO fia lãmekawo kple ŋutigbalẽ ƒe dzesiwo ƒe ƒuƒoƒo (synovitis, aklãdɔ, ƒunukpeƒetetedɔ, ƒumeŋuɖui, kple ƒumeŋuɖui), eye akɔta ƒe gli si le ŋgɔgbe (si me sternoclavicular joints, costothoracic joints, kple sternoacetabular elbow joints hã le) ye dzena wu, eye lumbar kple... cervical spine.Dzesi siwo bɔ wu le x-ray radiographs me enye vertebral body osteolysis with or not collapse, kpakple osteomalacia kple paraspinal ossification.MRI nye nɔnɔmetatawo ɖeɖe ƒe mɔnu si sea nu gɔme wu MRI nye nɔnɔmetataɖeɖemɔnu si sea veve wu, eye eƒe dzesi vevitɔwo dometɔ aɖewoe nye akɔta ƒe dzesi ƒe tɔtrɔ siwo keke ta alo le teƒe ɖeka le tsi-sensitive sequences kple cortical erosion kple irregularities at akɔtaƒuwo dome kadodo siwo le akɔtaƒuwo dome diskwo alo ŋgɔgbe nuwuƒewo, kple lãkusi falɛfalɛwo ƒe ʋuʋu.

De dzesii: Ŋutsu si xɔ ƒe 62 si ŋu SAPHO ƒe dɔlélea le. (a) Sagittal t2-weighted kple (b) computed tomography (CT) nɔnɔmetatawo ɖee fia be ƒu ƒe ʋuʋu le ŋgɔgbe ƒe lãkusi ƒe didime ŋu (aŋutsrɔe yibɔwo) Disk alo paravertebral fluid ƒe tɔtrɔ ɖedzesi aɖeke mele eŋu o. Wogbugbɔa L1 la ɖoa teƒe bubu ŋutɔ le nutete ƒe gbagbã xoxo aɖe megbe. (c) Axial CT ɖea ankylosis si le ɖusime costovertebral joint (ɣletividzesi) fiana. (d) Oblique coronal CT gbugbɔgawɔ ɖea akɔta ƒe akɔta ƒe akɔta ƒe akɔta ƒe akpa eve ƒe ankylosis (ɣletivi yibɔwo) fiana. (e) Ƒu ƒe fotoɖeɖe si ɖe radiotracer ƒe xɔxlɔ̃ fia le ƒunukpeƒe eve siwo ŋu dɔlélea le me (ɣletivi ɣiwo).

Spondyloarthropathy si do ƒome kple ʋumenugbagbeviɣidɔ

Dialysis-related spondyloarthropathy (DRS) nye dɔléle ƒe tɔtrɔ le dɔnɔ siwo le ʋumenugbagbeviɣidɔ wɔm ɣeyiɣi didi ŋu. Ebɔ wu le vidzidɔ ƒe akɔta eye zi geɖe la, edzena ne akɔta ƒe akpa si le akɔta dome la le kpuie, nuwuƒeawo tsrɔ̃, ƒu ƒe ʋuʋu ƒe anyimanɔmanɔ, ƒu yeyewo ƒe wɔwɔme, paraspinal infections/abscesses, kple teƒea ƒe ŋusẽdodo.

De dzesii: Ƒumeŋuɖui si keke ta le akɔta kple akɔta ƒe akɔta. Akɔta 5 ƒe akɔtaƒu ƒe ŋgɔgbekpa si le etame ƒe tsɔtsrɔ̃ kple axawo ƒe sclerotic hyperplasia (si wotsɔ aŋutrɔ dzĩ la ɖee fia). Abi siwo te ɖe wo nɔewo ŋu ƒe hyperplasia. Miame sacroiliac ƒunukpeƒe ƒe tsɔtsrɔ̃ kple ƒunukpeƒe si le axadzi ƒe ƒunukpeƒe ƒe tsɔtsrɔ̃, ƒu kuku geɖe siwo le eme, kple lãmeka siwo le abe abi ene ƒe dzidziɖedzi le teƒe ɖeka (si wotsɔ aŋutrɔ blɔwo ɖee fia).

De dzesii: MR si wodo ɖe ŋgɔ: Lumbar 4/5 disc bulge with vertebral rim osteophytes, ligamentum flavum ƒe dzidziɖedzi fũ, aklã ƒe mɔ si le kpuie vie, kple dural sac ƒe ŋgɔgbekpa ƒe tete. Akɔta 5 ƒe akɔta ƒe ŋutilã nye concave seɖoƒe eye woate ŋu akpɔe abe strips didi T1 kple T2 WI compression fat high signal, eye wokpɔa ŋgɔyiyi le ŋgɔyiyi megbe. Wokpɔa dzesi si mesɔ o ƒe akpa geɖe le akɔta 5 kple akɔta 1 ƒe nuwuƒewo te kple sacroiliac ƒunukpeƒewo te, dzesi si le sue le T1WI dzi eye dzesi si lolo vie le T2WI dzi, eye wokpɔa ŋgɔyiyi le ŋgɔyiyi ƒe fotowo me (aŋutsrɔe dzĩwo). Wokpɔ lãkusi falɛfalɛ siwo le ƒoƒom le akɔtaƒu ƒe ŋgɔgbekpa dzi, eye wokpɔe be wodo ŋusẽe le scan si wodo ŋusẽe me (aŋutsrɔe blɔ). Ƒu ƒe dzesi siwo le ilium, hip, sacrum kple femoral head me le akɔta ƒe akpa eveawo meɖe nusi mesɔ o si dze ƒã fia o, eye dzesi siwo le akɔta ƒe lãmeka siwo le eme kple egodo ŋu la sɔ, lãmekawo ƒe dometsotso siwo me kɔ eye ƒunukpeƒewo ƒe dometsotso siwo sɔ, dzesi aɖeke menɔ wo ŋu be wokeke eye wole kpuie o.

Akɔta ƒe Dɔléle

Nusi ɖe dzesi le aklãdɔléle ŋue nye be monocrystalline urate crystals (MUCs) ƒe ƒuƒoƒo ɖe akɔta. Akɔta ƒe akɔta koŋue gblẽa nu le aklãdɔléle ŋu. radiographs ɖea dzesi siwo menye tẽ o fiana eye CT ɖea ƒu ƒe ʋuʋu kple sclerotic margins fiana nyuie wu. mri ƒe ɖeɖefiawo menye esiwo me kɔ o.

De dzesii: CT plain scan ɖea ƒunukpeƒe ƒe teƒe si le kpuie kple ƒunukpeƒe ƒe akpa eve ƒe gbagbã fiana. Ele be woawɔ ƒunukpeƒetetedɔ atsɔ aɖo kpe dɔlélea dzi.

Ahɔhɔ̃mekawo ƒe dɔléle

Neurogenic spondylitis (NS), si nye ƒunukpeƒetetedɔ si gblẽa nu le ame ŋu si yia ŋgɔ, dzɔna ne ame ƒe seselelãme kple ame ŋutɔ ƒe nukpɔkpɔ bu. Nusi gbɔ wòtsona wue nye abi si woxɔna le aklã me si nye nuveviwɔame, si nye dɔléleawo ƒe 70%. Nu bubu siwo gbɔ wòtsonae nye suklidɔ, aklã me do ƒe dɔléle, kple ahɔhɔ̃mekawo ƒe dɔléle bubuwo abe peroneal muscular dystrophy kple Guillain-Barré syndrome ene. Le akpa si thoracolumbar kple lumbosacral junctions wɔna le kpekpeme tsɔtsɔ me ta la, woawoe nye teƒe siwo wòku ɖo wu.

NS ƒe dzesi siwo bɔ enye ƒu kakɛwo, ƒunukpeƒe siwo le akɔta dome ƒe masɔmasɔ kple masɔmasɔ si hea akɔta ƒe ŋutilã ƒe ʋuʋu vɛ, nuwuƒe geɖewo kple ƒunukpeƒe suewo ƒe ʋuʋu kpakple ƒu ƒe kpekpeme takpɔkpɔ le ƒunukpeƒetetedɔ me, kple lãkusi falɛfalɛwo hã.

De dzesii: Ŋutsu si xɔ ƒe 58 si ƒe akɔta ƒe ahɔhɔ̃mekawo ƒe dɔléle le. (a) Sagittal kple (b) coronal computed tomographic reconstructions ɖea akɔta ƒe nuwuƒe geɖe kple articular synovial joint erosions (aŋutsrɔewo) kple ƒu kakɛwo fiana. L2-L3 intervertebral disc unit ƒe tsɔtsrɔ̃ kple intervertebral space ƒe kekeɖenudɔwɔwɔ (ɣletividzesi). (c) Sagittal kple (d) axial t2-weighted magnetic resonance sequences si ɖo kpe L2-L3 intervertebral space ƒe kekeɖenudɔwɔwɔ dzi. tɔtrɔ ɖedzesiwo le aklã si ŋu dɔlélea le le megbe na L2-L3-L4. Effusion hã le lãkusi falɛfalɛ siwo le megbe kple ŋgɔgbe na akɔta ƒe dɔwɔwɔwo (ɣletiviwo).