Mu bufunze Engeri Y'endwadde z'omugongo ez'enjawulo

Obulwadde bw’omugongo bukola ebitundu 2% ku 7% ku yinfekisoni zonna ez’ebinywa n’amagumba ezireetebwa bakitiriya, ffene, era, okusinga obungi, obuwuka obusirikitu. Nga kitundu ku balwadde bonna abakwatibwa yinfekisoni z’omugongo basangibwa mu mugongo gw’omugongo, ekisukka katono kimu kya kusatu mu mugongo gw’omu kifuba, ate ebisigadde mu mugongo gw’omumwa gwa nnabaana.

Obulwadde bwa Purulent Infection

Purulent spinal discitis (PS) etera okuva ku bulwadde obusaasaana mu musaayi, nga Staphylococcus aureus y’esinga okulwaza, ng’esinga kukwata ku mugongo gw’omugongo, ate x-rays tezirina specificity na sensitivity mu ntandikwa y’obulwadde. Enhanced MRI y’enkola esinga okukozesebwa okuzuula amangu yinfekisoni z’omugongo; MRI eraga okuzimba kw’obusimu bw’amagumba n’okunywezebwa kw’emibiri gy’omugongo, disiki eziri wakati w’omugongo, ekifo ky’omugongo, ne/oba ebitundu ebigonvu ebiriraanyewo nga waliwo oba nga tebirina kutondebwa kwa bizimba ebisangibwa okusinga okumpi n’enkomerero z’omugongo.

Note: (a) Lateral lumbar spine radiograph eraga okufiirwa obuwanvu bwa disiki ya L4 -L3 n’okusaanawo kw’enkomerero eya waggulu eya L4 (akasaale). 

(b) Okuseerera okw’emabega okutono ku L3. okusaanyaawo disiki ya L3 - L4 n’enkyukakyuka ezikulugguka ku nkomerero eziriraanye (obusaale). 

(c) Ekifaananyi kya magnetic resonance (MR) ekiraga enkyukakyuka ezikulukuta ez’enkomerero z’omugongo n’akabonero akatali ka bulijjo ak’obusimu bw’amagumba obw’omugongo obuliraanyewo (akasaale). Ebitundu ebigonvu ebirina omugongo (prevertebral soft tissues) biba bizimba nnyo era nga birina enkyukakyuka mu kuzimba. 

(d) Sagittal t1 oluvannyuma lw’okukuba empiso y’enjawulo mu misuwa eraga akabonero akanywezeddwa mu busimu bw’amagumba (asterisk), akabonero akanywezeddwa mu kifo ky’amagumba n’ebitundu ebigonvu eby’omugongo. Weetegereze okuyingira kw’omwala ogw’omu makkati (akasaale).

Akafuba k’omugongo

Akafuba k’omugongo (TS), obulwadde bw’omugongo obutali bwa mafuta obusinga okuva ku Gram-positive Mycobacterium tuberculosis, n’ebifaananyi eby’okukuba ebifaananyi ebyawula TS ku PS biragiddwa mu kipande wansi:

Ebifaananyi eby’oluvannyuma biraga okusaanawo kw’amagumba, obuwanvu bwa disiki okukendeera n’ebizimba by’ebitundu ebigonvu nga waliwo oba nga tebiriimu calcification mu bitundu ebigonvu ebibyetoolodde.

Ku MRI, amaanyi ga t1 aga bulijjo ag’obubonero obutono n’amaanyi g’obubonero obw’amaanyi ag’ensengekera eziwulikika amazzi gazingiramu omubiri gw’omugongo ogw’omu maaso era guyinza okuyita mu kkubo lya subgamentous okutuuka ku mugongo omulala, okutwalira awamu awatali kuzingiramu disiki.

Ebiwandiiko: Omusajja ow’emyaka 65 ng’alina (a) ebizimba by’omugongo (axial ne (b) lumbar abscesses (asterisks) nga binywezeddwa septal ne wall enhancement (obusaale obweru).L3 okutuuka ku S1 vertebral body enhancement. Disiki wakati w’omugongo egwa nga tewali nkulaakulana ya maanyi. Okunyigirizibwa kw’ensawo ya Dural (akasaale akazungu). (c) ekifaananyi ky’okuzimba obuggya ct eky’okusaanyaawo omubiri gw’omugongo ogwa L3 okutuuka ku S1.

Obulwadde bwa Brucella

Brucellosis bulwadde bwa zoonosis obusangibwa mu nsi yonna obuva ku gram-negative bacillus. Kitera okuzingiramu omugongo gw’omugongo naddala L4.

Obulwadde buno butandikira mu kitundu eky’omu maaso eky’omubiri gw’omugongo ogwa intervertebral disc era buyinza okwonoona ennyondo entonotono. Paravertebral abscesses tezitera kubaawo era nga ntono mu sayizi okusinga TS. Ensengeka y’omugongo esigala nga bweri.

Weetegereze: Obulwadde bwa Brucella lumborum, ebifaananyi ebikubiddwa ku leediyo biraga okuzimba omugongo gw’omugongo, okuseerera mu maaso kw’omugongo gw’omugongo, okusaanawo okutali kwa bulijjo okufaanana kw’emitendera ku ludda olw’omu maaso olw’omubiri gw’omugongo, n’okutondebwa kw’amagumba aga cribriforms ku mabbali g’omugongo ogw’omu maaso.

Yinfekisoni za Fungal

Endwadde z’omugongo (FS) tezitera kulabika era zisinga kulabibwa mu balwadde abalina obusimu obuziyiza endwadde. Enkwaso nnyingi ziyinza okwenyigira mu nsonga eno, omuli Pseudomonas, Aspergillus, Bacillus, ne Coccidioides. Omugongo gw’ekifuba kye kifo ekisinga okubeerawo, era okufaananako ne TS, enkola y’okusiiga etandikira mu kitundu eky’omu maaso eky’omugongo era oluusi esobola okusaasaana mu mugongo ogutali kumpi.

Weetegereze: Ekifaananyi kya CT scan sagittal eky’omulwadde alina obulwadde bwa coccidioidomycosis. Ebiwundu by’amagumba ebitono ebitaliiko mabbali ga sclerotic bye bitera okubeera ku buwuka buno mu nnyanjula. okusaanyaawo okunene okwa T1 kuleeta okugwa kw’omugongo. Wadde nga waliwo ekiwundu ekinene eky’amagumba, ekifo ekiri wakati w’omugongo ekya C7-T1 kyakuumibwa, enkyukakyuka ey’engeri mu coccidioidomycosis (ekipande ekya ddyo) Sagittal MRT2WI ey’omulwadde y’omu ekakasa okukuuma omwezi gw’ekifo ekiri wakati w’omugongo gwa C7-T1, nga waliwo akabonero akakulu aka T2 akalaga nti disiki za C6-C7 zeenyigidde amangu. Ekiwundu ky’amagumba kyagaziwa mu ggumba erya subcortical bone mu maaso g’omubiri gw’omugongo, ekivaamu yinfekisoni y’ebitundu ebigonvu eby’omu maaso IV. Enkyukakyuka ezisiigibwa zisaasaana ku mitendera mingi, nga kyangu okuzuula engeri y’okusaasaana kw’ekika kya subgaligamentous, ekiyinza okuvaako ebiwundu ebingi ku mitendera egitali gya kumpi.

Obulwadde bwa Ankylosing Spondylitis

Ankylosing spondylitis (AS) bulwadde obutawona obuzimba obusimu obuziyiza endwadde obusinga okukosa omugongo era buyinza okuvaako obulumi obw’amaanyi obutawona olw’okuyungibwa kw’omugongo.

Ekizibu ekirala mu balwadde abalina AS kwe kukula kw’obulwadde bwa disiki obutono, era ku bifaananyi, AL esobola okwawulwa ku bulwadde bw’amagumba obuzimba olw’obulema obutunuulirwa mu mugongo gumu oba abiri oguliraanye, okufunda kw’ekifo kya disiki, n’ebitundu by’obulwadde bwa disiki obukola (reactive sclerosis) okwetooloola obulema bw’amagumba.

Weetegereze: Omulwadde alina obulwadde bwa ankylosing spondylitis, omusajja ow’emyaka 44 ng’alumizibwa obutawona mu mugongo ogwa wansi ate ng’atambula bulungi. Sagittal ct of (a) thoracic ne (b) lumbar spine bone windows ziraga diffuse ligamentous syndesmosis okuyita ku anterior longitudinal ligament (obusaale). Waliwo n’okufuuka amagumba n’okuyungibwa kw’emisuwa egy’omugongo egy’omugongo (obusaale bulagiddwa). (c) Ekifaananyi ky’omugongo ku ddaala ly’omugongo gw’omugongo kiraga okuyungibwa kw’ebintu eby’emabega n’ennyondo z’omugongo (articular synovial joints).

Obulwadde bw’obulwadde bw’amagumba

Enfunyiro SAPHO kitegeeza okugatta kw’okwolesebwa kw’ebinywa n’amagumba n’olususu (synovitis, embalabe, pustulosis, osteomalacia, ne osteomyelitis), nga ekisenge ky’ekifuba eky’omu maaso (nga mw’otwalidde n’ennyondo z’omugongo, ennyondo z’omugongo, n’ennyondo z’enkokola ez’omugongo (sternoacetabular elbow joints) ze zisinga okukwatibwako, n’eddirirwa eby’omugongo ne cervical spine.Ebisinga okweyoleka ku x-ray radiographs ye vertebral body osteolysis with or without collapse, wamu n’okusannyalala kw’amagumba n’okugwa kw’amagumba mu paraspinal.MRI ye nkola esinga okukwata ebifaananyi MRI ye nkola y’okukuba ebifaananyi esinga okuwulikika, era ebikulu bye yeeyoleka mulimu enkyukakyuka mu bubonero bw’omugongo obumanyiddwa ennyo oba obutunuuliddwa ku nsengekera ezikwata ku mazzi n’obutabeera bulungi ku ensengekera z’omugongo ezikwatagana wakati w’omugongo oba enkomerero z’omugongo ez’omu maaso, n’okuzimba ebitundu ebigonvu.

Weetegereze: Omusajja ow’emyaka 62 alina obulwadde bwa SAPHO. (a) Ebifaananyi bya sagittal t2-weighted ne (b) computed tomography (CT) biraga okufuuka amagumba mu musuwa ogw’omu maaso ogw’obuwanvu (obusaale obuddugavu) Tewali buzibu bunene bwa disiki oba amazzi g’omugongo. L1 ekyusibwa nnyo oluvannyuma lw’okumenya okunyigirizibwa okukadde. (c) Axial CT eraga ankylosis y’ekiwanga kya costovertebral ekya ddyo (asterisk). (d) Okuddamu okuzimba oblique coronal CT kulaga obulwadde bw’omugongo gw’omu kifuba ogw’enjuyi zombi (bilateral thoracic ribcage clavicle ankylosis) (emmunyeenye enjeru). (e) Sikaani y’amagumba eraga okutwalibwa kwa radiotracer mu binywa byombi ebikoseddwa (emmunyeenye enjeru).

Obulwadde bwa Spondyloarthropathy obukwatagana n’okulongoosa omusaayi

Dialysis-related spondyloarthropathy (DRS) nkyukakyuka ya pathologic mu balwadde abali ku hemodialysis okumala ebbanga eddene. Kisinga kubeera mu mugongo gw’omumwa gwa nnabaana era kitera okweyoleka n’okufunda kw’ekifo ekiri wakati w’omugongo, okusaanawo kw’enkomerero, obutaba na bulwadde bwa sclerosis, okutondebwa kw’amagumba amapya, yinfekisoni/ebizimba mu bitundu by’omugongo, n’okunyweza ekifo.

Weetegereze: Obulwadde bw’amagumba obw’amaanyi mu kifuba n’omugongo. Okusaanawo kw’olukonko olw’omu maaso olw’omugongo 5 ogw’omugongo nga guliko obulwadde bwa sclerotic hyperplasia obw’emmwaanyi (ekiragibwa n’akasaale akamyufu). Obulwadde bw’enkovu obubeera okumpi. Okusaanyizibwawo kw’ekiwanga kya kkono eky’omugongo n’okusaanyaawo ekitundu ky’omugongo eky’ebbali ekya ilium, amagumba amangi agafudde munda, n’okusaasaana kw’ebitundu ebiringa enkovu mu kitundu (ekiragibwa n’obusaale obwa bbululu).

Note: Enhanced MR: Lumbar 4/5 disc bulge with vertebral rim osteophytes, hypertrophy of ligamentum flavum, okufunda katono kw’omukutu gw’omugongo, n’okunyigirizibwa kw’olukonko olw’omu maaso olw’ensawo y’omugongo. Omubiri gw’omugongo ogw’omugongo 5 guliko obukonde obutono era guyinza okulabibwa ng’emiguwa egy’akabonero akawanvu aka T1 ne T2 WI compression fat high signal, era okunywezebwa kulabibwa oluvannyuma lw’okunywezebwa. Ebitundu ebingi eby’obubonero obutali bwa bulijjo birabibwa wansi w’enkomerero z’omugongo 5 ne sacral 1 ne wansi w’ennyondo za sacroiliac, nga waliwo siginiini entono ku T1WI n’akabonero akasingako katono ku T2WI, ate okunywezebwa kulabibwa ku sikaani ez’okutumbula (obusaale obumyufu). Okugonza kw’ebitundu ebigonvu ku mabbali g’omugongo ogw’omu maaso kwalabibwa, era okunywezebwa kwalabibwa ku sikaani eyongezeddwa (akasaale ka bbulu). Obubonero bw’amagumba g’omutwe gwa ilium, hip, sacrum ne femoral head ku njuyi zombi ez’ekisambi tebwalaga buzibu bwonna obweyoleka, era obubonero bw’ebinywa by’omu kifuba ogw’omunda n’ogw’ebweru bwali bwa bulijjo, nga bulimu ebituli mu binywa ebitegeerekeka obulungi n’ebituli by’ennyondo ebya bulijjo, nga tewali bubonero bwa kugaziwa na kufunda.

Gaasi y’omugongo

Gaasi y’omugongo emanyiddwa olw’okuteekebwa kw’ebiwuka ebiyitibwa monocrystalline urate crystals (MUCs) mu mugongo. Gaasi w’omugongo okusinga akwata omugongo gw’omugongo. radiographs ziraga okweyoleka okutali kwa njawulo era CT esinga okulaga okukulugguka kw’amagumba nga kuliko sclerotic margins. okwolesebwa kwa mri si kwa njawulo.

Weetegereze: CT plain scan eraga okufunda kw’ekifo ky’ennyondo n’okusaanawo kw’enjuyi z’ennyindo ku njuyi zombi. Arthrocentesis yeetaagibwa okukakasa nti omuntu azuuliddwa.

Obulwadde bw’obusimu obuyitibwa neurospondylitis

Neurogenic spondylitis (NS), obulwadde bw’enkizi obugenda mu maaso obusaanyaawo, bubaawo oluvannyuma lw’okufiirwa okuwulira n’okutegeera kw’omuntu. Ekisinga okuvaako kwe buvune bw’omugongo obulumwa, nga buno bukola ebitundu 70% ku balwadde. Ebirala ebivaako obulwadde bwa sukaali, obulwadde bw’omugongo, n’obuzibu obulala mu busimu nga peroneal muscular dystrophy ne Guillain-Barré syndrome. Olw’omulimu gw’ensengekera z’omu kifuba n’enkulungo mu kusitula obuzito, bye bifo ebisinga okukwatibwako.

Ebitera okweyoleka mu NS bye bitundutundu by’amagumba, obutakwatagana mu binywa wakati w’omugongo n’obutakwatagana ekivaako omubiri gw’omugongo okuseerera, endplates eziwera n’okukulugguka kw’ennyondo entonotono wamu n’okukuuma density y’amagumba mu sclerosis, era n’obunene bw’ebitundu ebigonvu.

Weetegereze: Omusajja ow’emyaka 58 ng’alina obulwadde bw’omugongo. (a) Sagittal ne (b) coronal computed tomographic reconstructions ziraga endplates eziwera ez’omugongo ez’omugongo n’okukulugguka kw’ennyondo z’omugongo (articular synovial joint erosions) (obusaale) n’ebitundu by’amagumba. Okusaanyaawo ekitundu kya disiki wakati w’omugongo ogwa L2-L3 n’okugaziwa kw’ekifo ekiri wakati w’omugongo (emmunyeenye). (c) Ensengekera za magineeti ezizitowa sagittal ne (d) axial t2-weighted magnetic resonance sequences ezikakasa okugaziwa kw’ekifo kya L2-L3 wakati w’omugongo. enkyukakyuka ennene mu mugongo ogukoseddwa emabega wa L2-L3-L4. Waliwo n’okukulukuta mu bitundu ebigonvu eby’emabega n’eby’omu maaso g’enkola z’omugongo (emmunyeenye).