Incamake Yibiranga Indwara Zinyuranye Zumugongo

Indwara yumugongo igizwe na 2% kugeza 7% byindwara zose zifata imitsi iterwa na bagiteri, ibihumyo, kandi gake cyane na parasite. Hafi ya kimwe cya kabiri cyibibazo byanduye byumugongo biherereye mu ruti rwumugongo, birenze gato kimwe cya gatatu cyumugongo wa thoracic, naho ibindi bisigaye mu ruti rwumugongo.

Indwara yuzuye

Indwara ya spinal discitis (PS) ubusanzwe iterwa n'indwara ikwirakwizwa na hematogene ikwirakwizwa, hamwe na Staphylococcus aureus niyo itera indwara ikunze kwibasira cyane, akenshi iba irimo uruti rw'umugongo, na x-imirasire idafite umwihariko n'ubukangurambaga mu ntangiriro z'indwara. MRI yongerewe imbaraga nuburyo bwo guhitamo mugusuzuma hakiri kare indwara zumugongo; MRI yerekana amagufwa yo mu magufa no kuzamura imibiri ya vertebral, disque intervertebral, umwanya wibyorezo, hamwe na / cyangwa ibibyimba byoroshye byoroshye cyangwa bidafite ibibyimba biherereye hafi yimpera zurugingo.

Icyitonderwa: (a) Umuyoboro wumugongo wa radiyo yerekana L4 -L3 gutakaza uburebure bwa disiki no gusenya impera yo hejuru ya L4 (umwambi). 

(b) Inyandiko yoroheje yinyuma kuri L3. gusenya disiki ya L3 - L4 hamwe nimpinduka zangiza kumpera zegeranye (imyambi). 

. Uturemangingo tworoheje twa prevertebral twigaragaza cyane kandi dufite impinduka. 

. Reba indentation ya kanal yo hagati (umwambi).

Igituntu cy'umugongo

Igituntu cy'uruti rw'umugongo (TS), indwara ikunze kwibasirwa na granulomatous granulomatous spinal iterwa na Gram-positif Mycobacterium igituntu, hamwe n'ibiranga amashusho bitandukanya TS na PS bigaragara mu mbonerahamwe ikurikira:

Amaradiyo yatinze yerekana kwangirika kw'amagufwa, kugabanuka k'uburebure bwa disiki hamwe n'ibisebe byoroheje byoroheje hamwe cyangwa bitabaruwe kubara byoroshye.

Kuri MRI, ubusanzwe t1 ubukana bwikimenyetso gito hamwe nuburemere bwibimenyetso byinshi byurwego rwimiterere-y-amazi bikubiyemo umubiri wimbere winyuma kandi birashobora kwambukiranya inzira igana ku zindi nyababyeyi, muri rusange nta ruhare rwa disiki.

Icyitonderwa: Umugabo wimyaka 65 ufite (a) axial na (b) ibibyimba byo munda (asterisks) hamwe na septal hamwe nurukuta (imyambi yera) .L3 kugeza S1 kuzamura umubiri. Disiki yaguye hagati ya disikete idafite iterambere ryinshi. Dural sac compression (umwambi wera). (c) ct kwiyubaka ishusho ya L3 kugeza S1 kurimbuka kwumubiri.

Indwara ya Brucella

Brucellose ni zoonose ikwirakwizwa kwisi yose iterwa na garama-mbi ya bacillus. Akenshi harimo uruti rw'umugongo, cyane cyane L4.

Indwara itangirira mu gice cyimbere cyumubiri wurugingo rwa disikuru kandi ishobora kwangiza ingingo nto. Ibibyimba bya paravertebral bibaho kenshi kandi ni bito mubunini kuruta TS. Anatomy ya vertebral ikomeza kuba ntamakemwa.

Icyitonderwa: Indwara ya Brucella lumborum, radiografi yerekana sclerose ya vertebrae, kunyerera imbere ya vertebrae, kunyerera nkintambwe idasanzwe kurimbuka imbere yumubiri wurugingo, no gushiraho amagufwa yamagufwa kumpera yimbere yumubiri wurugingo.

Indwara yibihumyo

Indwara yumugongo (FS) ntisanzwe kandi ikunze kugaragara kubarwayi badafite ubudahangarwa. Ibihumyo byinshi birashobora kubigiramo uruhare, harimo Pseudomonas, Aspergillus, Bacillus, na Coccidioides. Uruti rw'umugongo rwa thoracic ni urubuga rusanzwe, kandi rusa na TS, inzira yandura itangirira mu gice cyimbere cyurugingo kandi rimwe na rimwe irashobora gukwirakwira kuri vertebrae idahuje.

Icyitonderwa: CT scan ishusho yumurwayi urwaye coccidioidomycose. Amagufwa make adafite marike ya sclerotic asanzwe yiyi patogene mubitekerezo. gusenya kwinshi kwa T1 biganisha ku gusenyuka. Nubwo ibikomere byinshi, amagufwa ya C7-T1 yarazigamwe, impinduka iranga coccidioidomycose (iburyo) Sagittal MRT2WI yumurwayi umwe iremeza ko ukwezi kwa C7-T1 hagati y’imyanya ndangagitsina, hamwe n’ikimenyetso gikomeye cya T2 cyerekana ko hakiri kare disiki ya C6-C7. Igufwa ry'amagufwa ryagutse mu magufwa ya subcortical imbere y'umubiri wa vertebral, bikaviramo kwandura inyama zoroshye imbere IV. Impinduka zandura zikwirakwira mu nzego nyinshi, byoroshye kumenya uburyo bwo gukwirakwiza ubwoko bwa subligamentous, bushobora gukomeretsa ibikomere byinshi kurwego rudasanzwe.

Ankylose Spondylitis

Ankylose spondylitis (AS) ni indwara idakira yangiza autoimmune yibasira cyane cyane urutirigongo kandi ishobora gutera ububabare budashira buturuka ku guhuza umugongo.

Iyindi ngorane ku barwayi barwaye AS ni iterambere ryindwara zidasanzwe, kandi kumashusho, AL irashobora gutandukanywa na spondylitis inflammatory hamwe nudusembwa twibanze muri vertebrae imwe cyangwa ibiri yegeranye, kugabanya umwanya wa disiki, hamwe nuduce twa sclerose idakira ikikije inenge ya osteolitike.

Icyitonderwa: Umurwayi urwaye ankylose spondylitis, umugabo wimyaka 44 ufite ububabare budakira bwumugongo hamwe no kugenda. Citt ya ct ya (a) thoracic na (b) amagufwa yumugongo yamagufa yerekana diffuse ligamentous syndesmose kuruhande rwimbere rwimbere (imyambi). Hariho kandi osifisation hamwe no guhuza lumbar interspinous ligaments (imyambi yerekanwe). .

Indwara ya Osteomyelitis

Amagambo ahinnye ya SAPHO yerekeza ku guhuza imitsi ya musculoskeletal na cutaneous (synovitis, acne, pustulose, osteomalacia, na osteomyelitis), hamwe nurukuta rw'imbere rwa thoracic (harimo ingingo zifata sternoclavicular, ingingo zifata imyakura, hamwe nudusimba twinshi twinshi hamwe nu mugongo w’umugongo. Imirasire ya x-ray ni umubiri wa osteolysis wintangangore hamwe no gusenyuka, kimwe na osteomalacia na ossification ya paraspinal.MRI niyerekana cyane amashusho ya MRI ni uburyo bwo gufata amashusho cyane, kandi ibyigaragaza byingenzi birimo impinduka zerekana ibimenyetso byurururururururururururururururururururururururi rwimitsi hamwe nudusembwa twihuza ryimyanya ndangagitsina.

Icyitonderwa: Umusore wimyaka 62 ufite syndrome ya SAPHO. . L1 irasubirwamo cyane nyuma yo kuvunika gushaje. (c) Axial CT yerekana ankylose yiburyo bukwiye (asterisk). . (e) Gusikana amagufwa yerekana radiotracer ifata ingingo zombi zanduye (inyenyeri zera).

Dialysis ifitanye isano na Spondyloarthropathie

Dialysis ifitanye isano na spondyloarthropathie (DRS) nimpinduka yindwara kubarwayi kuri hemodialyse yigihe kirekire. Bikunze kugaragara cyane mu ruti rw'umugongo kandi mubisanzwe bigaragaza kugabanuka k'umwanya uhuriweho, gusenya impera, kubura sclerose, amagufwa mashya, kwandura parasipine / ibibyimba, no gushimangira umwanya.

Icyitonderwa: Osteoporose nini ya lumbar na sacral pelvis. Kurimbuka kwa anterosuperior margin ya lumbar 5 vertebrae hamwe na sclerotic hyperplasia ya marge (yerekanwa numwambi utukura). Indwara ya hyperplasia yegeranye. Kurimbuka kwa sacroiliac ibumoso hamwe no gusenya hejuru yinyuma ya ilium, amagufwa menshi yimbere yimbere, hamwe ninkovu zimeze nka tissue hyperplasia (yerekanwa n imyambi yubururu).

Icyitonderwa: Byongerewe MR: Lumbar 4/5 disike ya vertebral rim osteophytes, hypertrophy ya ligamentum flavum, kugabanya gato umuyoboro wumugongo, no kwikanyiza kumpera yimbere yumufuka wigihe. Umubiri wumugongo 5 uringaniye kandi urashobora kugaragara nkimirongo miremire ya T1 na T2 WI yogusenyera ibinure byinshi, kandi kwiyongera kugaragara nyuma yo kwiyongera. Ibice byinshi byikimenyetso kidasanzwe bigaragara munsi yimpera ya lumbar 5 na sacral 1 no munsi ya sacroiliac, hamwe nibimenyetso bike kuri T1WI hamwe nikimenyetso cyo hejuru gato kuri T2WI, kandi kuzamura kugaragara kuri scan yo kuzamura (imyambi itukura). Inyama zoroheje zibyimbye kuruhande rwimbere rwintangangore ya sacral yagaragaye, kandi kuzamura byagaragaye kuri scan yongerewe (umwambi wubururu). Ibimenyetso by'amagufa ya ilium, ikibuno, sacrum n'umutwe w'igitsina gore ku mpande zombi z'igitereko ntago byerekanaga ko bidasanzwe, kandi ibimenyetso by'imitsi yo munda y'imbere n'inyuma byari bisanzwe, bifite imitsi isobanutse neza hamwe n’ibyuho bisanzwe, nta kimenyetso cyo kwaguka no kugabanuka.

Umugongo

Uruti rw'umugongo rurangwa no kubika monocrystalline urate kristal (MUCs) mu ruti rw'umugongo. Uruti rw'umugongo rugira ingaruka cyane cyane ku ruti rw'umugongo. amaradiyo yerekana kwigaragaza bidasanzwe kandi CT iranga neza isuri yamagufwa hamwe na sclerotic margins. mri kwigaragaza ntabwo ari ngombwa.

Icyitonderwa: CT isikana yerekana umwanya uhuriweho hamwe no gusenya impande zombi. Arthrocentez irasabwa kwemeza indwara.

Neurospondylitis

Neurogenic spondylitis (NS), arthropathie yangiza itera imbere, ibaho nyuma yo gutakaza ibyiyumvo na proprioception. Impamvu zikunze kugaragara ni ihahamuka ryumugongo, bingana na 70%. Izindi mpamvu zirimo diyabete mellitus, uruti rw'umugongo n'indwara zifata urwungano ngogozi, nizindi ndwara zifata ubwonko nka dystrofi ya peroneal muscular na syndrome ya Guillain-Barré. Bitewe n'uruhare rwa thoracolumbar na lumbosacral ihuza uburemere, ni urubuga rukunze kubigiramo uruhare.

Kugaragara kwa NS ni ibice byamagufwa, guhuza ingingo zidahuza hamwe no kudahuza biganisha ku kunyerera kwumubiri wurugingo, impera nyinshi hamwe nisuri ntoya hamwe no kubungabunga ubwinshi bwamagufwa muri sclerose, ndetse nubwinshi bwimitsi.

Icyitonderwa: Umugabo wimyaka 58 ufite uruti rwumugongo. . Kurimbuka kwa L2-L3 igice cya disiki ihuza hamwe no kwagura umwanya uhuza (inyenyeri). . ihinduka rikomeye ryumugongo wanduye inyuma ya L2-L3-L4. Hariho kandi gusohora mubice byoroheje byinyuma inyuma ninyuma yimikorere (asterisks).