Nchịkọta nke njirimara nke ọrịa ọkpụkpụ azụ dị iche iche

Ọkpụkpụ discitis bụ 2% ruo 7% nke ọrịa musculoskeletal niile nke nje bacteria, fungi na-akpata, na, ọ na-adịkarị obere, site na nje nje. Ihe dị ka ọkara nke ọrịa ọnya ọ bụla dị na spine lumbar, ntakịrị ihe karịrị otu ụzọ n'ụzọ atọ na spine thoracic, na nke fọdụrụ na spine cervical.

Ọrịa purulent

A na-ebutekarị purulent spinal discitis (PS) site na ọrịa hematogenous na-ekesa, na Staphylococcus aureus bụ nje na-ebutekarị ọrịa, na-emetụtakarị spine lumbar, na x-ray enweghị nkọwa na nghọta na mmalite nke ọrịa ahụ. MRI emelitere bụ usoro nhọrọ maka nchọpụta mmalite nke ọrịa ọkpụkpụ azụ; MRI na-egosiputa edema ụmị ọkpụkpụ na nkwalite nke vertebral ozu, diski intervertebral, oghere epidural, na / ma ọ bụ gburugburu anụ ahụ dị nro na-enwe ma ọ bụ na-enweghị nhazi nke dị n'akụkụ akụkụ vertebral.

Rịba ama: (a) Igwe redio na-egbuke egbuke na-egosi L4 -L3 diski elu ọnwụ na mbibi nke elu njedebe nke L4 (akụ). 

(b) Mwepụ azụ dị nro na L3. mbibi nke diski L3 - L4 nwere mgbanwe na-emebi emebi na nsonye njedebe (akụ). 

(c) Igwefoto resonance magnetik (MR) na-egosi mgbanwe mkparị nke vertebral endplates na mgbaàmà na-adịghị mma nke ụmị ọkpụkpụ vertebral dị n'akụkụ (akụ). Anụ ahụ dị nro nke prevertebral bụ nke nwere oke edematous ma nwee mgbanwe mkpali. 

(d) Sagittal t1 mgbe intravenous iche injection na-egosi enwekwukwa mgbaama na ụmị ọkpụkpụ (akara mmuke), enwekwukwa mgbaama na epidural oghere na prevertebral soft anụ ahụ. Rịba ama ntinye nke ọwa etiti (akụ).

Ụkwara nta nke ọkpụkpụ azụ

Ụkwara nta nke spine (TS), ọrịa na-adịghị purulent granulomatous spinal ọrịa nke Gram-positive Mycobacterium ụkwara nta na-akpata, na ihe oyiyi nke dị iche na TS na PS ka egosiri na tebụl dị n'okpuru:

Igwe redio n'oge na-egosi mbibi ọkpụkpụ, mbelata ịdị elu diski na ọnya anụ ahụ dị nro nwere ma ọ bụ na-enweghị nhazi nke anụ ahụ dị nro gbara ya gburugburu.

Na MRI, ihe mgbaàmà t1 na-ahụkarị na-enwe mmetụta dị elu nke usoro mmetụta nke mmiri na-agụnye akụkụ vertebral nke dị n'ihu ma nwee ike ịgbatị site na ụzọ subligamentous na vertebrae ndị ọzọ, n'ozuzu na-enweghị gụnyere diski.

Ihe ndetu: nwoke 65 nke nwere (a) axial na (b) abscesses lumbar (asterisks) na nkwalite septal na mgbidi (akụ ọcha) .L3 ka S1 nkwalite ahụ vertebral. Diski intervertebral dara ada na-enweghị nkwalite dị mkpa. Mkpịsị ike nke akpa akpa (akụ ọcha). (c) ct nwughari onyonyo nke L3 ruo S1 mbibi ahụ vertebral.

Ọrịa Brucella

Brucellosis bụ zoonosis na-efe efe zuru ụwa ọnụ nke nje bacillus gram-negative kpatara. Ọ na-agụnyekarị ọkpụkpụ azụ azụ, karịsịa L4.

Ọrịa ahụ na-amalite na akụkụ ihu nke akụkụ vertebral nke diski intervertebral ma nwee ike imebi obere nkwonkwo. Ọkpụkpụ paravertebral na-eme obere oge ma pere mpe karịa TS. Ahụhụ vertebral ka na-adịkwaghị.

Rịba ama: ọrịa Brucella lumborum, ihe ngosi redio na-egosi sclerosis nke vertebrae lumbar, nkwụsịtụ na-aga n'ihu nke lumbar vertebrae, nkwụsị nke oge na-adịghị anya dị ka akụkụ azụ nke vertebral ahụ, na nhazi nke ọkpụkpụ ọkpụkpụ na akụkụ ihu nke vertebral ahụ.

Ọrịa fungal

Ọrịa fungal spinal ọrịa (FS) dị ụkọ ma na-ahụkarị ya na ndị ọrịa immunosuppressed. Ọtụtụ fungi nwere ike itinye aka, gụnyere Pseudomonas, Aspergillus, Bacillus, na Coccidioides. Ọkpụkpụ thoracic bụ ebe a na-ahụkarị, yana dịka TS, usoro na-efe efe na-amalite na akụkụ ihu nke vertebrae ma nwee ike gbasaa mgbe ụfọdụ na vertebrae na-abụghị nke dị n'akụkụ.

Mara: CT scan sagittal onyonyo nke onye ọrịa nwere coccidioidomycosis. Ọnya ọkpụkpụ nwere oke na-enweghị oke sclerotic bụ ụdị ọrịa nje a na ngosi. mbibi buru ibu nke T1 na-eduga na ọdịda vertebral. N'agbanyeghị nnukwu ọnya ọkpụkpụ, a na-echekwa oghere intervertebral C7-T1, mgbanwe njirimara na coccidioidomycosis (panel aka nri) Sagittal MRT2WI nke otu onye ọrịa ahụ na-akwado nchekwa nke ọnwa oghere intervertebral C7-T1, nke nwere akara T2 dị ịrịba ama na-egosi ntinye aka mbụ nke diski C6-C7. Ọkpụkpụ ọkpụkpụ gbatịpụrụ n'ime ọkpụkpụ dị n'okpuru ala na ihu vertebral, na-ebute ọrịa anụ ahụ dị nro nke dị n'ihu IV. Mgbanwe na-efe efe na-agbasa n'ọtụtụ ọkwa, na-achọpụta ngwa ngwa usoro mgbasa ozi nke ụdị subligamentous, nke nwere ike iduga ọtụtụ ọnyá na ọkwa ndị na-adịghị n'akụkụ.

Spondylitis ankylosing

Ankylosing spondylitis (AS) bụ ọrịa autoimmune nke na-adịghị ala ala nke na-emetụta ọkpụkpụ azụ ma nwee ike ibute oke mgbu na-adịghị ala ala site na njikọ ọkpụkpụ azụ.

Ihe mgbagwoju anya ọzọ na ndị ọrịa nwere AS bụ mmepe nke ọrịa diski a kpaara ókè, na eserese, AL nwere ike ịmata ọdịiche dị na spondylitis na-egbuke egbuke site na ntụpọ focal na otu ma ọ bụ abụọ dị n'akụkụ vertebrae, na-ebelata ohere diski, na mpaghara nke reactive sclerosis gburugburu ntụpọ osteolytic.

Rịba ama: Onye na-arịa ọrịa ankylosing spondylitis, nwoke dị afọ 44 nwere ihe mgbu na-adịghị ala ala na njedebe nke mmegharị ahụ. Sagittal ct of (a) thoracic na (b) windo ọkpụkpụ lumbar na-egosi agbasa ligamentous syndesmosis n'akụkụ eriri ogologo ogologo oge (akụ). Enwekwara ossification na ngwakọta nke eriri interspinous lumbar (akụ egosipụtara). (c) Ihe oyiyi Coronal na ọkwa ọkpụkpụ lumbar na-egosi njikọ nke ihe ndị dị n'azụ na nkwonkwo synovial articular (akụ).

Osteomyelitis Syndrome

Acronym SAPHO na-ezo aka na nchikota nke musculoskeletal na akpụkpọ anụ ahụ (synovitis, acne, pustulosis, osteomalacia, na osteomyelitis), na mgbidi thoracic nke dị n'ihu (gụnyere nkwonkwo sternoclavicular, nkwonkwo costothoracic, na sternoacetabular elbowmbar nkwonkwo, nke kachasị na-esote ya bụ nkwonkwo ọkpụkpụ azụ azụ). ngosipụta na x-ray radiographs bụ vertebral ahụ osteolysis na ma ọ bụ na-enweghị ọdịda, yana osteomalacia na paraspinal ossification.MRI bụ ihe kasị emetụ n'ahụ imaging MRI bụ ihe kasị emetụ n'ahụ image modality, na isi ihe ngosi ya na-agụnye mgbasawanye ma ọ bụ na-elekwasị anya vertebral mgbaàmà mgbanwe na mmiri-mmetụta usoro usoro na cortical erosion na intervertebral juputara na intervertebral juputara na intervertebral juputara na intervertebral juputara na intervertebral juputara. akụkụ ihu ihu, na edema anụ ahụ dị nro.

Mara: Nwoke dị afọ 62 nwere ọrịa SAPHO. (a) Sagittal t2-weighted na (b) ihe oyiyi CT (CT) na-egosi ossification nke eriri ogologo ogologo oge (akụ ojii) Ọ dịghị ihe mgbagwoju anya dị ịrịba ama nke diski ma ọ bụ mmiri paravertebral. A na-emegharị L1 nke ukwuu ka mgbaji mgbawa ochie gasịrị. (c) Axial CT na-egosi ankylosis nke nkwonkwo aka nri costovertebral (akara mmuke). (d) Oblique coronal CT mwughari na-egosi bilateral thoracic ribcage clavicle ankylosis (asterisks ojii). (e) Nyocha ọkpụkpụ na-egosi nnabata rediotracer na nkwonkwo abụọ metụtara (asterisks ọcha).

Spondyloarthropathy metụtara dialysis

Ọkpụkpụ spondyloarthropathy metụtara dialysis (DRS) bụ mgbanwe pathologic na ndị ọrịa na hemodialysis ogologo oge. Ọ na-adịkarị na spain cervical ma na-enyekarị mbelata nke oghere intervertebral, mbibi nke ihe nsọtụ, enweghị sclerosis, ọkpụkpụ ọhụrụ, ọrịa paraspinal / abscesses, na ike nke oghere.

Mara: Nnukwu osteoporosis nke lumbar na pelvis sacral. Nbibi nke oke anterosuperior nke lumbar 5 vertebrae nwere hyperplasia sclerotic nke oke (nke a na-acha uhie uhie gosipụtara). hyperplasia na-afụ ụfụ n'akụkụ. Mbibi nke nkwonkwo sacroiliac aka ekpe na mbibi nke mpụta articular elu nke ilium, ọtụtụ ọkpụkpụ nwụrụ anwụ dị n'ime, yana hyperplasia anụ ahụ dị n'ime ya (nke akụ na-acha anụnụ anụnụ gosipụtara).

Rịba ama: MR kwalitere: Lumbar 4/5 disc bulge with vertebral rim osteophytes, hypertrophy nke ligamentum flavum, ntakịrị mbelata nke ọkpụkpụ azụ azụ, na mkpakọ nke ihu ihu nke sac dural. The lumbar 5 vertebral ahụ nwere oke concave na enwere ike ịhụ ya dị ka ibe nke ogologo T1 na T2 WI mkpakọ abụba dị elu, a na-ahụkwa nkwalite mgbe nkwalite. A na-ahụ ọtụtụ ihe nkedo nke mgbaàmà na-adịghị mma n'okpuru njedebe nke lumbar 5 na sacral 1 na n'okpuru nkwonkwo sacroiliac, nke nwere akara dị ala na T1WI na obere akara dị elu na T2WI, na nkwalite na-ahụ maka nkwalite nkwalite (akụ uhie). A na-ahụ anụ ahụ dị nro na-agbakọba n'akụkụ ihu nke vertebrae sacral, na nkwalite a hụrụ na nyocha emelitere (akụ na-acha anụnụ anụnụ). Ihe mgbaàmà nke ọkpụkpụ nke ilium, hip, sacrum na isi femoral n'akụkụ abụọ nke pelvis egosighi ihe ọ bụla doro anya, na ihe mgbaàmà nke akwara pelvic dị n'ime na nke dị n'èzí bụ ihe nkịtị, na-enwe oghere muscle doro anya na nkwonkwo nkwonkwo nkịtị, na-enweghị ihe ịrịba ama nke ịgbasawanye na nkwụsị.

Ọkpụkpụ azụ

A na-amata gout spinal site na nkwụnye ego nke kristal monocrystalline urate (MUCs) n'ime ọkpụkpụ azụ. Ọkpụkpụ azụ azụ na-emetụtakarị ọkpụkpụ azụ azụ. Ihe onyonyo redio na-egosi ngosipụta na-enweghị nkọwa yana CT na-eji akụkụ sclerotic mara mma nke ọkpụkpụ. Ngosipụta mri enweghị nkọwa.

Mara: CT plain scan na-egosi mbelata oghere nkwonkwo na mbibi elu akụkụ abụọ. A chọrọ arthrocentesis iji kwado nchoputa ahụ.

Neurospondylitis

Neurogenic spondylitis (NS), ogbu na nkwonkwo na-emebi emebi na-aga n'ihu, na-eme mgbe ọ nwesịrị mmetụta uche na ikike ime ihe. Ihe na-akpatakarị bụ mmerụ ahụ nke ọkpụkpụ azụ, nke na-akpata 70% nke ikpe. Ihe ndị ọzọ kpatara ya gụnyere ọrịa shuga mellitus, ọrịa cavernous eriri afọ, na nsogbu akwara ozi ndị ọzọ dị ka peroneal muscular dystrophy na ọrịa Guillain-Barré. N'ihi ọrụ nke thoracolumbar na lumbosacral junctions na ibu ibu, ha bụ saịtị ndị a na-ejikarị eme ihe.

Ihe ngosi a na-ahụkarị nke NS bụ iberibe ọkpụkpụ, nkwụsị nke nkwonkwo intervertebral na enweghị nkwekọrịta na-eduga na nkwụsị nke vertebral ahụ, ọtụtụ njedebe njedebe na obere nkwonkwo nkwonkwo yana ichekwa njupụta nke ọkpụkpụ na sclerosis, yana anụ ahụ dị nro.

Mara: Nwoke dị afọ 58 nwere spain neuropathic. (a) Sagittal na (b) nrụgharị ihe ndekọ ọnụ ọgụgụ nke coronal na-egosi ọtụtụ akụkụ vertebral lumbar na nkwonkwo nkwonkwo synovial (akụ) na iberibe ọkpụkpụ. Mbibi nke L2-L3 intervertebral disc unit na mgbasawanye nke oghere intervertebral (akara mmuke). (c) Sagittal na (d) usoro resonance magnetik axial t2 na-akwado mgbasawanye nke oghere intervertebral L2-L3. mgbanwe dị ịrịba ama nke ọkpụkpụ azụ azụ emetụtara n'azụ na L2-L3-L4. A na-enwekwa nsị na anụ ahụ dị nro n'azụ na n'ihu na usoro spinous (asterisks).