Hōʻuluʻulu manaʻo o nā ʻano o nā maʻi maʻi ʻokoʻa

ʻO ka discitis spinal ka 2% a 7% o nā maʻi musculoskeletal a pau i hoʻokumu ʻia e ka bacteria, fungi, a, ʻoi aku ka paʻakikī, e nā parasites. Aia ma kahi o ka hapalua o nā maʻi āpau o ke kuamoʻo i loko o ke kuamoʻo lumbar, ʻoi aku ma mua o hoʻokahi hapakolu o ka spine thoracic, a ʻo ke koena i ka spine cervical.

ʻO ka maʻi purulent

ʻO Purulent spinal discitis (PS) ke kumu maʻamau e ka maʻi hematogenously disseminated, me Staphylococcus aureus ka mea maʻamau maʻamau, pili pinepine i ka spine lumbar, a me nā x-ray nele i ka kikoʻī a me ka naʻau i ka wā mua o ka maʻi. ʻO ka MRI i hoʻonuiʻia keʻano o ka kohoʻana no kaʻike muaʻana i nā maʻi o ke kuamoʻo; Hōʻike ka MRI i ka edema marrow iwi a me ka hoʻonui ʻana i nā kino vertebral, intervertebral discs, epidural space, a / a i ʻole a puni nā ʻiʻo palupalu me ka ʻole a i ʻole ke kūkulu ʻana i ka abscess ma kahi kokoke i nā endplates vertebral.

'Ōlelo Aʻo: (a) Lateral lumbar spine radiograph e hōʻike ana i ka L4 -L3 disc kiʻekiʻe nalowale a me ka luku ʻana i ka ʻaoʻao hope o L4 (arrow). 

(b) Paheʻe hope haʻahaʻa ma L3. ka luku ʻia ʻana o ka diski L3 - L4 me nā hoʻololi erosive i nā endplates pili (nā pua). 

(c) ʻO ke kiʻi magnetic resonance (MR) e hōʻike ana i nā loli erosive o nā endplates vertebral a me ka hōʻailona maʻamau o ka iwi iwi vertebral pili (arrow). ʻO nā ʻiʻo palupalu prevertebral he edematous a loaʻa nā loli inflammatory. 

(d) Sagittal t1 ma hope o ka hoʻokaʻawale intravenous hōʻike i ka hōʻailona hoʻonui i ka iwi iwi (asterisk), hoʻonui i ka hōʻailona ma ka epidural space a me ka ʻiʻo palupalu prevertebral. E hoʻomaopopo i ke kuhi o ke kahawai waena (arrow).

Ka maʻi maʻi iwi kuamoʻo

ʻO ka maʻi maʻi o ka iwi kuamoʻo (TS), ka maʻi maʻamau o ka maʻi spinal granulomatous non-purulent i hoʻokumu ʻia e ka Gram-positive Mycobacterium tuberculosis, a me nā hiʻohiʻona kiʻi e hoʻokaʻawale i ka TS mai PS e hōʻike ʻia ma ka papa ma lalo nei.

Hōʻike nā lekiō hope i ka luku ʻia ʻana o ka iwi, ka emi ʻana o ke kiʻekiʻe o ka disc a me nā abscesses ʻiʻo palupalu me ka ʻole a i ʻole ka helu ʻana o ka ʻiʻo palupalu a puni.

Ma ka MRI, ʻo ka t1 haʻahaʻa haʻahaʻa haʻahaʻa haʻahaʻa a me ka hōʻailona kiʻekiʻe o nā kaʻina wai-sensitive e pili ana i ke kino vertebral mua a hiki ke hoʻonui i ke ala subligamentous i nā vertebrae ʻē aʻe, maʻamau me ka ʻole o ka disc.

Nā memo: 65 makahiki kāne kāne me (a) axial a me (b) lumbar abscesses (asterisks) me ka septal a me ka hoʻonuiʻana i ka paia (nā pua keʻokeʻo). ʻO ka disc intervertebral i hāʻule me ka hoʻonui nui ʻole. Hoʻopiʻi puʻupuʻu dural (arrow keʻokeʻo). (c) ct kiʻi hana hou o L3 a i ka S1 vertebral kino luku.

ʻO ka maʻi maʻi Brucella

ʻO Brucellosis kahi zoonosis endemic honua i hoʻokumu ʻia e kahi bacillus gram-negative. Hoʻopili pinepine ia i ka spine lumbar, ʻoi aku ka L4.

Hoʻomaka ka maʻi ma ka ʻaoʻao mua o ke kino vertebral o ka disverse intervertebral a hiki ke hōʻino i nā hui liʻiliʻi. ʻAʻole liʻiliʻi pinepine nā abscesses paravertebral a ʻoi aku ka liʻiliʻi ma mua o TS. Paʻa mau ke anatomy vertebral.

Nānā: ʻO ka maʻi Brucella lumborum, hōʻike nā radiographs i ka sclerosis o ka vertebrae lumbar, ka paheʻe mua o ka vertebrae lumbar, ka luku like ʻole ʻana i ka ʻaoʻao mua o ke kino vertebral, a me ka hoʻokumu ʻana o nā cribriforms iwi ma ka ʻaoʻao mua o ke kino vertebral.

Nā maʻi fungal

He kakaikahi ka maʻi iwi kuamoʻo fungal (FS) a ʻike pinepine ʻia i nā maʻi immunosuppressed. Hiki ke hoʻopili ʻia nā haʻuki he nui, me Pseudomonas, Aspergillus, Bacillus, a me Coccidioides. ʻO ka spine thoracic ka pūnaewele maʻamau, a like me TS, hoʻomaka ke kaʻina hana maʻi ma ka ʻaoʻao mua o ka vertebrae a hiki i kekahi manawa ke hoʻolaha i ka vertebrae nonadjacent.

Nānā: CT scan sagittal kiʻi o ka mea maʻi me ka coccidioidomycosis. ʻO nā ʻeha iwi liʻiliʻi me ka ʻole o nā palena sclerotic he ʻano maʻamau o kēia pathogen i ka hōʻike. ʻO ka luku nui ʻana o T1 alakaʻi i ka hāʻule ʻana o ka vertebral. ʻOiai ka nui o ka ʻeha iwi, ua mālama ʻia ka C7-T1 intervertebral space, kahi hoʻololi hiʻohiʻona i ka coccidioidomycosis (pane ʻākau) Sagittal MRT2WI o ka mea maʻi hoʻokahi e hōʻoia i ka mālama ʻana i ka mahina intervertebral C7-T1, me kahi hōʻailona T2 koʻikoʻi e hōʻike ana i ke komo mua ʻana o nā disc C6-C7. Hoʻonui ʻia ka ʻeha iwi i loko o ka iwi subcortical ma mua o ke kino vertebral, ka hopena i ka maʻi maʻi palupalu mua IV. Hoʻolaha nā hoʻololi maʻi i nā pae he nui, e ʻike maʻalahi i ke ʻano o ka hoʻolaha ʻana o ke ʻano subligamentous, hiki ke alakaʻi i nā ʻeha he nui ma nā pae ʻole.

Ankylosing Spondylitis

ʻO Ankylosing spondylitis (AS) kahi maʻi maʻi autoimmune maʻi maʻi e hoʻopilikia nui i ka spine a hiki ke alakaʻi i ka ʻeha mau loa mai ka hui ʻana o ka spinal.

ʻO kekahi pilikia ʻē aʻe i nā maʻi me AS ʻo ia ka ulu ʻana o ka maʻi diski liʻiliʻi, a ma ke kiʻi ʻana, hiki ke hoʻokaʻawale ʻia ʻo AL mai ka spondylitis inflammatory e nā defects focal i loko o hoʻokahi a ʻelua paha vertebrae e pili ana, ka liʻiliʻi o ka disc space, a me nā wahi o ka sclerosis reactive e puni ana i nā defects osteolytic.

'Ōlelo Aʻo: ʻO ka mea maʻi me ka spondylitis ankylosing, he kāne 44 makahiki me ka ʻeha hope o lalo a me ke ʻano o ka neʻe. Hōʻike ka sagittal ct o (a) thoracic a me (b) lumbar spine bone windows i ka diffuse ligamentous syndesmosis ma ka ligament longitudinal mua (nā pua). Aia kekahi ossification a me ka hui ʻana o nā ligaments interspinous lumbar (hōʻike ʻia nā pua). (c) Hōʻike ʻia ke kiʻi Coronal ma ka pae ʻōiwi lumbar i ka hui ʻana o nā mea hope a me nā hui synovial articular (nā pua).

Osteomyelitis Syndrome

ʻO ka acronym SAPHO e pili ana i ka hui pū ʻana o nā hōʻike musculoskeletal a me nā ʻili (synovitis, acne, pustulosis, osteomalacia, a me osteomyelitis), me ka paia o ka ʻōpū mua (me nā hui sternoclavicular, nā hui costothoracic, a me ka sternoacetabular elbow ami) i ukali ʻia e ka xray maʻamau a ʻike ʻia ka spine xray. ʻO nā radiographs he osteolysis o ke kino vertebral me ka hāʻuleʻole a me ka hāʻuleʻole paha, a me ka osteomalacia a me ka paraspinal ossification. ʻuʻuku ʻiʻo.

Nānā: He kāne 62 makahiki me ka maʻi SAPHO. (a) Sagittal t2-kaumaha a me (b) computed tomography (CT) nā kiʻi e hōʻike ana i ka ossification o ka ligament longitudinal mua (nā pua ʻeleʻele) ʻAʻohe mea ʻino nui o ka disc a i ʻole ka wai paravertebral. Hoʻonohonoho hou ʻia ka L1 ma hope o ka haʻihaʻi koʻikoʻi kahiko. (c) Hōʻike ka Axial CT i ka ankylosis o ka hui costovertebral kūpono (asterisk). (d) Oblique coronal CT reconstruction hoike bilateral thoracic ribcage clavicle ankylosis (black asterisk). (e) Iwi e hōʻike ana i ka lawe ʻana o ka radiotracer ma nā hui ʻelua i hoʻopilikia ʻia (nā asterisk keʻokeʻo).

Spondyloarthropathy pili i ka dialysis

ʻO ka spondyloarthropathy pili i ka dialysis (DRS) kahi hoʻololi pathologic i nā maʻi ma ka hemodialysis lōʻihi. He mea maʻamau ia i ka spine cervical a hōʻike pinepine ʻia me ka liʻiliʻi o ka intervertebral space, ka luku ʻana i nā endplates, ka nele o ka sclerosis, ka hana iwi hou, nā maʻi paraspinal / abscesses, a me ka hoʻoikaika ʻana o ka hakahaka.

Nānā: ʻO ka osteoporosis nui o ka lumbar a me ka sacral pelvis. ʻO ka lukuʻana i ka palena anterosuperior o ka lumbar 5 vertebrae me ka hyperplasia sclerotic o nā palena (i hōʻikeʻia e ka puaʻulaʻula). ʻO ka hyperplasia scarring pili. Ka luku ʻia ʻana o ka hui sacroiliac hema me ka luku ʻana i ka ʻili o ka ʻili o ka ilium, nā iwi make i loko, a me ka hyperplasia kikoʻī e like me ka maʻi ʻulaʻula (hōʻike ʻia e nā pua polū).

Hoʻomaopopo: Hoʻonui MR: Lumbar 4/5 disc bulge me ka vertebral rim osteophytes, hypertrophy o ka ligamentum flavum, ka liʻiliʻi liʻiliʻi o ke kahawai spinal, a me ka paʻi ʻana o ka ʻaoʻao mua o ka ʻeke dural. ʻO ka lumbar 5 vertebral kino he palena concave a hiki ke ʻike ʻia e like me nā ʻāpana o ka T1 lōʻihi a me T2 WI hōʻailona momona momona, a ʻike ʻia ka hoʻonui ʻana ma hope o ka hoʻonui ʻana. ʻIke ʻia nā ʻāpana he nui o ka hōʻailona maʻamau ma lalo o nā papa hope o ka lumbar 5 a me ka sacral 1 a ma lalo o nā hui sacroiliac, me ka hōʻailona haʻahaʻa ma T1WI a me ka hōʻailona kiʻekiʻe iki ma T2WI, a ʻike ʻia ka hoʻonui ʻana ma nā scans hoʻonui (nā pua ʻulaʻula). Ua ʻike ʻia ka mānoanoa o ka ʻiʻo palupalu ma ka ʻaoʻao mua o ka iwi ʻaoʻao sacral, a ua ʻike ʻia ka hoʻonui ʻia ma ka scan hoʻonui (arrow blue). ʻO nā hōʻailona iwi o ka ilium, ʻūhā, sacrum a me ke poʻo femoral ma nā ʻaoʻao ʻelua o ke pelvis ʻaʻole i hōʻike i kahi ʻano ʻino ʻole, a ʻo nā hōʻailona o nā ʻiʻo o loko a me waho he mea maʻamau, me nā ʻokoʻa ʻiʻo a me nā ʻāpana hui maʻamau, ʻaʻohe hōʻailona o ka hoʻonui a me ka haiki.

Spinal Gout

Hōʻike ʻia ka spinal gout e ka waiho ʻana o nā kristal urate monocrystalline (MUCs) i loko o ka iwi kuamoʻo. Hoʻopilikia nui ka spinal gout i ka lumbar spine. hōʻike nā radiographs i nā hōʻike kikoʻī ʻole a ʻoi aku ka maikaʻi o ka hōʻike ʻana o CT i ka ʻāʻili ʻana o ka iwi me nā palena sclerotic. ʻaʻole kikoʻī nā hōʻike mri.

'Ōlelo Aʻo: Hōʻike ka CT scan paʻa i ka hōʻemi ʻana o ka hakahaka a me ka luku ʻana i ka ʻili o ka ʻaoʻao bilateral. Pono ʻo Arthrocentesis e hōʻoia i ka ʻike.

ʻO Neurospondylitis

ʻO ka neurogenic spondylitis (NS), kahi maʻi arthropathy holomua, e loaʻa ma hope o ka nalowale o ka manaʻo a me ka proprioception. ʻO ke kumu maʻamau ka hōʻeha ʻeha spinal cord, ʻo ia ka 70% o nā hihia. ʻO nā kumu ʻē aʻe e pili ana i ka maʻi diabetes mellitus, ka maʻi cavernous spinal cord, a me nā maʻi neurologic ʻē aʻe e like me peroneal muscular dystrophy a me Guillain-Barré syndrome. Ma muli o ke kuleana o ka thoracolumbar a me ka lumbosacral junctions i ke kaumaha kaumaha, ʻo lākou nā pūnaewele i hoʻopili pinepine ʻia.

ʻO nā hōʻike maʻamau o ka NS he mau ʻāpana iwi, intervertebral joint irregularities a me inconsistencies e alakaʻi ana i ka paheʻe kino o ka vertebral, nā endplates lehulehu a me nā erosions liʻiliʻi liʻiliʻi a me ka mālama ʻana i ka nui o ka iwi i ka sclerosis, a me nā ʻiʻo palupalu.

'Ōlelo Aʻo: 58 makahiki kane me ka neuropathic spine. (a) Sagittal a me (b) coronal computed tomographic reconstructions hōʻike nui lumbar vertebral endplates a articular synovial joint erosions (arrows) me nā ʻāpana iwi. ʻO ka luku ʻia ʻana o ka L2-L3 intervertebral disc unit me ka hoʻonui ʻana o ka intervertebral space (asterisk). (c) Sagittal a me (d) axial t2-weighted magnetic resonance sequences e hōʻoia ana i ka hoʻonui ʻana o ka L2-L3 intervertebral space. nā hoʻololi nui o ke kuamoʻo i hoʻopili ʻia ma hope o L2-L3-L4. Aia kekahi effusion i loko o nā ʻiʻo palupalu ma hope a ma mua o nā kaʻina spinous (asterisks).