Pfupiso Yemaitiro Eakasiyana Spinal Infections

Spinal discitis inotora 2% kusvika 7% yezvirwere zvese zvemusculoskeletal zvinokonzerwa nebhakitiriya, fungi, uye, kazhinji, nemaparasite. Inenge hafu yezviitiko zvose zvezvirwere zvepelinha zviri mu lumbar spine, zvishoma kudarika chikamu chimwe chete muzvitatu mu thoracic spine, uye yakasara mumutsipa wekervical.

Purulent Infection

Purulent spinal discitis (PS) inowanzokonzerwa nehutachiona hwehutachiona hwehutachiona hwehutachiona, uye Staphylococcus aureus ndiyo inowanzoita pathogen, inowanzobatanidza lumbar spine, uye x-rays inoshayikwa zvakananga uye kunzwisisika mumatanho ekutanga echirwere. Kuwedzerwa MRI ndiyo nzira yekusarudza kwekutanga kuongororwa kwezvirwere zvemusana; MRI inoratidzira bone marrow edema uye kukwidziridzwa kwemitumbi ye vertebral, intervertebral discs, epidural space, uye / kana yakapoteredza zvinyoro zvinyoro zvine kana pasina abscess formation inowanikwa kunyanya pedyo ne vertebral endplates.

Cherechedza: (a) Lateral lumbar spine radiograph inoratidza L4 -L3 disc kureba kurasikirwa uye kuparadzwa kwepamusoro endplate yeL4 (museve). 

(b) Kutsvedza kwemashure kunyoro paL3. kuparadzwa kweL3 - L4 disc ine erosive shanduko kune ari pedyo endplates (miseve). 

(c) Magnetic resonance (MR) mufananidzo unoratidza erosive shanduko yevertebral endplates uye chiratidzo chisina kujairika chepedyo vertebral bone marrow (museve). Iwo prevertebral soft tissues akanyanya edema uye ane kuzvimba shanduko. 

(d) Sagittal t1 mushure mekudzivirira kusiyanisa jekiseni inoratidza chiratidzo chakasimbiswa mumapfupa emapfupa (asterisk), chiratidzo chinowedzerwa mu epidural space uye prevertebral soft tissue. Cherechedza kupinza kwepakati canal (museve).

Spinal Tuberculosis

Tuberculosis yemuzongoza (TS), iyo inowanzozivikanwa isina-purulent granulomatous spinal infection inokonzerwa neGram-positive Mycobacterium tuberculosis, uye mifananidzo yekufungidzira inosiyanisa TS kubva kuPS inoratidzwa mutafura iri pasi apa:

Yakanonoka radiographs inoratidza kuparadzwa kwemapfupa, kuderera kwe disc kureba uye zvinyoro zvinyoro zviputi zvine kana pasina calcification yezvinyoro zvakatenderedza tishu.

Pamusoro peMRI, iyo inowanzoita t1 yakaderera-signal intensity uye high-signal intensity ye-fluid-sensitive sequences inosanganisira anterior vertebral body uye inogona kuwedzera kuburikidza ne subligamentous nzira kune dzimwe vertebrae, kazhinji pasina kubatanidza disc.

Notes: 65 ane makore ane makore ane (a) axial uye (b) lumbar abscesses (asterisks) ane septal uye rusvingo kuwedzera (white arrows) L3 kune S1 vertebral body enhancement. Yakaputsika intervertebral disc isina kusimudzira kwakakosha. Dural sac compression (white arrow). (c) ct yekuvakazve mufananidzo weL3 kune S1 vertebral muviri kuparadzwa.

Brucella Infection

Brucellosis chirwere chepasi rose chezoonosis chinokonzerwa ne gram-negative bacillus. Inowanzobatanidza lumbar spine, kunyanya L4.

Chirwere chinotanga mune chikamu chepamberi chemuviri we vertebral we intervertebral disc uye inogona kukuvadza majoini maduku. Paravertebral abscesses inoitika zvishoma kazhinji uye idiki muhukuru kupfuura TS. Iyo vertebral anatomy inoramba yakasimba.

Cherechedza: Brucella lumborum infection, radiographs inoratidza sclerosis ye lumbar vertebrae, mberi kutsvedza kwechiuno chechiuno, kuparadzwa kusina kukwana-kufanana nekuparadzwa kumucheto wepamberi we vertebral body, uye kuumbwa kwebhoni cribriforms kune anterior margin ye vertebral body.

Zvirwere zveFungal

Fungal spinal zvirwere (FS) hazviwanzo uye zvinowanzoonekwa muvarwere vasina kudzivirirwa. Mafungu mazhinji anogona kubatanidzwa, kusanganisira Pseudomonas, Aspergillus, Bacillus, uye Coccidioides. Iyo thoracic musana ndiyo nzvimbo yakajairika, uye yakafanana neTS, chirwere chinotapukira chinotanga muchikamu chepamberi che vertebrae uye dzimwe nguva chinogona kupararira kune vertebrae isiri pedyo.

Cherechedza: CT scan sagittal mufananidzo wemurwere ane coccidioidomycosis. Yakaganhurirwa maronda ebhoni asina sclerotic margins akajairika eiyi pathogen mumharidzo. kuparadzwa kukuru kweT1 kunotungamirira kukuputika kwe vertebral. Pasinei nehosha yakakura yebhoni, nzvimbo yeC7-T1 intervertebral yakachengetedzwa, kuchinja kwechimiro mu coccidioidomycosis (kurudyi panel) Sagittal MRT2WI yemurwere mumwe chete inosimbisa kuchengetedzwa kweC7-T1 intervertebral space mwedzi, ine chiratidzo chikuru cheT2 chinoratidza kubatanidzwa kwekutanga kweC6-C7 discs. Bony lesion yakawedzera mu subcortical bone anterior kune vertebral body, zvichikonzera anterior soft tissue infection IV. Shanduko dzehutachiona dzakapararira kusvika kumatanho akawanda, zviri nyore kuziva nzira yekuparadzira yemhando ye subligamentous, iyo inogona kutungamirira kune maronda akawanda pamazinga asina pedyo.

Ankylosing spondylitis

Ankylosing spondylitis (AS) chirwere chisingaperi chinoputika chinokanganisa chinokonzera musana uye chinogona kutungamirira kumarwadzo asingagumi kubva kumusana wepelinha.

Chimwe chinonetsa muvarwere vane AS ndiko kukura kwechirwere chediki disc, uye pakufungidzira, AL inogona kusiyaniswa nekuputika spondylitis nefocal defects mune imwe kana maviri ari pedyo vertebrae, kuderera kweiyo disc space, uye nzvimbo dze reactive sclerosis dzakapoteredza osteolytic defects.

Cherechedza: Murwere ane ankylosing spondylitis, 44-ane makore ane makore ane marwadzo asingagumi emusana uye mashoma ekufamba. Sagittal ct ye (a) thoracic uye (b) lumbar spine bone mahwindo anoratidza diffuse ligamentous syndesmosis pamwe neanterior longitudinal ligament (miseve). Kune zvakare ossification uye fusion ye lumbar interspinous ligaments (miseve inoratidzwa). (c) Coronal image pa lumbar spine level inoratidza fusion ye posterior elements uye articular synovial joints (miseve).

Osteomyelitis Syndrome

Acronym SAPHO inoreva kusanganiswa kwemusculoskeletal uye cutaneous kuratidzwa (synovitis, acne, pustulosis, osteomalacia, uye osteomyelitis), ine anterior thoracic wall (kusanganisira sternoclavicular joints, costothoracic joints, uye sternoacetabular elbow inobatanidzwa nemakumbo akawanda) musana.Zviratidzo zvinonyanya kuitika pa x-ray radiographs ndeye vertebral body osteolysis ine kana isina kuputsika, pamwe ne osteomalacia uye paraspinal ossification.MRI ndiyo inonyanya kuoma yekufungidzira MRI ndiyo inonyanya kuoma yekufungidzira maitiro, uye kuratidzwa kwayo kukuru kunosanganisira kupararira kana kuti focal vertebral signal inoshanduka pane fluid-sensitive segulances pane intervertebral sequences uye intervertebral ensensitive sequences uye intervertebral essification. intervertebral discs kana anterior endplates, uye soft tissue edema.

Cherechedza: murume ane makore makumi matanhatu nemaviri ane SAPHO syndrome. (a) Sagittal t2-inorema uye (b) computed tomography (CT) mifananidzo inoratidza ossification yeanterior longitudinal ligament (black arrows) Hapana kukanganisa kwakakosha kwe disc kana paravertebral fluid. Iyo L1 inokwidziridzwa zvakanyanya mushure meiyo yekare compression kutyoka. (c) Axial CT inoratidza ankylosis yekodzero costovertebral joint (asterisk). (d) Oblique coronal CT reconstruction inoratidza bilateral thoracic ribcage clavicle ankylosis (black asterisks). (e) Bone scan inoratidza radiotracer inotorwa mumajoini ese akabatwa (white asterisks).

Dialysis-inoenderana Spondyloarthropathy

Dialysis-inoenderana nespondyloarthropathy (DRS) ishanduko yepathologic muvarwere pane kwenguva refu hemodialysis. Iyo inowanzoonekwa mumutsara wekervical uye inowanzopa nekuderera kwe intervertebral space, kuparadzwa kwe endplates, kushaya sclerosis, kuumbwa kwemapfupa matsva, zvirwere zveparaspinal / abscesses, nekusimbiswa kwenzvimbo.

Cherechedza: Kuwedzera osteoporosis yechiuno uye sacral pelvis. Kuparadzwa kweanterosuperior margin ye lumbar 5 vertebrae ine sclerotic hyperplasia yemumucheto (inoratidzwa nemuseve mutsvuku). Pedyo nemavanga hyperplasia. Kuparara kwechikamu chekuruboshwe chesacroiliac pamwe nekuparadzwa kwe lateral articular surface ye ilium, mapfupa akawanda emukati akafa, uye mavanga-akaita setishu hyperplasia (inoratidzwa nemiseve yebhuruu).

Cherechedza: Enhanced MR: Lumbar 4 / 5 disc bulge ne vertebral rim osteophytes, hypertrophy ye ligamentum flavum, kuderera kuduku kwemugero wepelinha, uye kudzvinyirira kwemukati wepamberi we dural sac. Iyo lumbar 5 vertebral body ine zvishoma concave uye inogona kuonekwa semitsetse yakareba T1 uye T2 WI compression mafuta yakakwira chiratidzo, uye kukwidziridzwa kunoonekwa mushure mekusimudzira. Mavara akawanda echiratidzo chisina kujairika anoonekwa pasi pekupedzisira kwe lumbar 5 uye sacral 1 uye pasi pemajoini e sacroiliac, nechiratidzo chakaderera paT1WI uye chiratidzo chepamusoro paT2WI, uye kukwidziridzwa kunoonekwa pakuvandudza scans (miseve yakatsvuka). Zvinyoro zvinyoro zvakakora pamucheto wepamberi wesacral vertebrae zvakaonekwa, uye kukwidziridzwa kwakaonekwa pakuvandudzwa scan (blue museve). Zviratidzo zvepfupa zveilium, hip, sacrum uye musoro wechikadzi kumativi ose ehuputi hazvina kuratidza kusakanganiswa kwakajeka, uye zviratidzo zvemukati nekunze kwezvipembenene zvepilvic zvaive zvakajairika, zvine mhasuru dzakajeka uye zvipembenene zvakajairika, pasina zviratidzo zvekuwedzera uye kuderera.

Spinal Gout

Spinal gout inoratidzwa nekuiswa kwemonocrystalline urate crystals (MUCs) mumuzongoza. Spinal gout inonyanya kukanganisa lumbar spine. radiographs inoratidza nonspecific kuratidzwa uye CT inoratidzira zviri nani kukukurwa kwebhonzo ne sclerotic margins. mri kuratidzwa hakuna kutaurwa.

Ongorora: CT plain scan inoratidza yakabatana nzvimbo kutetepa uye bilateral articular pamusoro pekuparadzwa. Arthrocentesis inodiwa kusimbisa kuongororwa.

Neurospondylitis

Neurogenic spondylitis (NS), inoparadza inofambira mberi arthropathy, inoitika mushure mekurasikirwa kwekunzwa uye proprioception. Chikonzero chinonyanya kukosha ndechekukuvadza kwepinal cord, iyo inotora 70% yematambudziko. Zvimwe zvinokonzeresa zvinosanganisira chirwere cheshuga mellitus, spinal cord cavernous chirwere, uye mamwe matambudziko eurological akadai peroneal muscular dystrophy uye Guillain-Barré syndrome. Nekuda kwebasa reiyo thoracolumbar uye lumbosacral junctions mukurema-kutakura, iwo ndiwo anonyanya kubatanidzwa nzvimbo.

Maonero akajairika eNS zvimedu zvemabhonzo, intervertebral joint irregularities uye kusawirirana kunotungamirira kune vertebral body slippage, akawanda endplates uye madiki erosions pamwe nekuchengetedzwa kwefupa density mu sclerosis, uyewo soft tissue mass.

Ongorora: murume ane makore makumi mashanu nemasere ane neuropathic musana. (a) Sagittal uye (b) coronal computed tomographic reconstructions inoratidza akawanda lumbar vertebral endplates uye articular synovial joint erosions (miseve) ine zvimedu zvemapfupa. Kuparadzwa kweL2-L3 intervertebral disc unit nekuwedzera kwe intervertebral space (asterisk). (c) Sagittal uye (d) axial t2-inorema magnetic resonance sequences inosimbisa kuwedzera kweL2-L3 intervertebral space. kuchinja kukuru kwemusana wepelinha wakakanganiswa shure kweL2-L3-L4. Iko kunewo effusion mune zvinyoro zvinyoro shure uye anterior kune spinous maitiro (asterisks).