IsiShwankathelo seMpawu zeZosulelo ezohlukeneyo zoMnqonqo

I-Spinal discitis yenza i-2% ukuya kwi-7% yazo zonke izifo ze-musculoskelet ezibangelwa ibhaktheriya, i-fungi, kwaye, ngokungaqhelekanga, ngama-parasites. Phantse isiqingatha sazo zonke iimeko zokusuleleka komgogodla zifumaneka kwi-lumbar spine, kancinane ngaphezu kweyesithathu kwi-thoracic spine, kunye nentsalela kumqolo wesibeleko.

Usulelo lwePurulent

I-Purulent spinal discitis (PS) idla ngokubangelwa lusulelo olusasazwa nge-hematogenous, kunye ne-Staphylococcus aureus yeyona pathogen ixhaphake kakhulu, idla ngokubandakanya i-lumbar spine, kunye ne-x-rays engenakho ukuchaneka kunye novelwano kwizigaba zokuqala zesifo. I-MRI ephuculweyo yindlela yokukhetha ukuxilongwa kwangaphambili kwezifo zomgogodla; I-MRI ibonisa i-edema yamathambo kunye nokuphucula imizimba ye-vertebral, i-intervertebral discs, indawo ye-epidural, kunye / okanye izicubu ezithambileyo ezijikelezayo kunye okanye ngaphandle kokubunjwa kwe-abscess ebekwe ngokuyinhloko kufuphi ne-vertebral endplates.

Qaphela: (a) I-Lateral lumbar spine radiograph ebonisa i-L4 -L3 ilahleko yobude bediski kunye nokutshatyalaliswa kwe-endplate ephezulu ye-L4 (utolo). 

(b) Isiliphu sangasemva esithambileyo kwi-L3. ukutshatyalaliswa kwediski ye-L3 - L4 kunye neenguqu ezikhukhulayo kwii-endplates ezikufutshane (iintolo). 

(c) Umfanekiso we-Magnetic resonance (MR) obonisa utshintsho oluguquguqukayo lwee-endplates ze-vertebral kunye nomqondiso ongaqhelekanga we-vertebral bone umongo osondeleyo (utolo). Izicubu ezithambileyo ze-prevertebral zibonakala zi-edema kwaye zineenguqu ezivuthayo. 

(d) I-Sagittal t1 emva kwe-injection ye-intravenous intravenous ibonisa isignali eyongeziweyo kwi-bone marrow (i-asterisk), isignali ephuculweyo kwindawo ye-epidural kunye ne-prevertebral soft tissue. Qaphela ukujongwa komjelo osembindini (utolo).

Isifo sephepha soMnqongo

I-Tuberculosis yomqolo (TS), eyona nto ixhaphakileyo ye-non-purulent i-granulomatous ye-spinal infection ebangelwa yi-Gram-positive Mycobacterium tuberculosis, kunye neempawu zomfanekiso ezahlula i-TS kwi-PS ziboniswe kwitheyibhile engezantsi:

Iiradiographs zamva nje zibonisa ukutshatyalaliswa kwamathambo, ukuncipha kobude bediski kunye namathumba athambileyo wezicubu kunye okanye ngaphandle kokubalwa kwezicubu ezithambileyo ezijikelezileyo.

Kwi-MRI, i-t1 ye-t1 ye-low-signal intensity kunye ne-high-signal intensity ye-fluid-sensitive sequences ibandakanya i-vertebral yangaphambili yomzimba kwaye inokwandisa ngendlela engaphantsi kwe-subligamentous ukuya kwamanye ama-vertebrae, ngokubanzi ngaphandle kokubandakanya i-disc.

Amanqaku: Indoda eneminyaka eyi-65 ubudala kunye (a) ne-axial kunye (b) ne-lumbar abscesses (i-asterisk) ene-septal kunye nodonga oluphuculweyo (iintolo ezimhlophe) .L3 ukuya kwi-S1 yokuphucula umzimba we-vertebral. Idiskhi ye-intervertebral ewileyo ngaphandle kophuculo olubalulekileyo. Uxinzelelo lwe-Dural sac (utolo olumhlophe). (c) ct umfanekiso wokwakhiwa kwakhona kwe-L3 ukuya kwi-S1 ukutshatyalaliswa komzimba we-vertebral.

Usulelo lweBrucella

I-Brucellosis sisifo se-zoonosis emhlabeni wonke esibangelwa yintsholongwane yegram-negative. Ihlala ibandakanya i-lumbar spine, ngakumbi i-L4.

Isifo siqala kwinxalenye yangaphambili ye-vertebral body ye-disc intervertebral kwaye inokonakalisa amalunga amancinci. Amathumba e-Paravertebral ayenzeka rhoqo kwaye ancinci ngobukhulu kune-TS. I-vertebral anatomy ihlala injalo.

Qaphela: Usulelo lwe-Brucella lumborum, i-radiographs ibonisa i-sclerosis ye-lumbar vertebrae, i-slippage ehamba phambili ye-lumbar vertebrae, ukutshatyalaliswa okungaqhelekanga okufana nokunyathela kumda wangaphambili we-vertebral body, kunye nokwakheka kwee-cribriforms zamathambo kumda wangaphambili we-vertebral body.

Usulelo lomngundo

Usulelo lwe-Fungal spinal (FS) lunqabile kwaye luhlala lubonwa kwizigulana ezigonyelweyo. Iifungi ezininzi ezinokuthi zibandakanyeke, kuquka iPseudomonas, iAspergillus, iBacillus, kunye neCoccidioides. I-thoracic spine yindawo eqhelekileyo, kwaye ifana ne-TS, inkqubo yokusuleleka iqala kwindawo yangaphambili ye-vertebrae kwaye ngamanye amaxesha inokusasazeka kwi-vertebrae engekho kufuphi.

Qaphela: Umfanekiso we-CT scan sagittal wesigulane esine-coccidioidomycosis. Izilonda ezinqamlekileyo zamathambo ngaphandle kwemida ye-sclerotic ziqhelekileyo kule pathogen kwinkcazo. ukutshatyalaliswa okukhulu kwe-T1 kukhokelela ekuweni kwe-vertebral. Nangona i-bony lesion ebanzi, indawo ye-C7-T1 ye-intervertebral igcinwe, utshintsho oluphawulekayo kwi-coccidioidomycosis (iphaneli elungileyo) i-Sagittal MRT2WI yesigulane esifanayo iqinisekisa ukugcinwa kwenyanga ye-C7-T1 ye-intervertebral space, kunye nesibonakaliso esibalulekileyo se-T2 esibonisa ukubandakanyeka kwangaphambili kweediski ze-C6-C7. I-Bony lesion yandiswe kwithambo le-subcortical elingaphambili ukuya kumzimba we-vertebral, okukhokelela ekusulelekeni kwezicubu ezithambileyo zangaphambili IV. Iinguqu ezithathelwanayo zisasazeka kumanqanaba amaninzi, ukuchonga ngokulula indlela yokusabalalisa uhlobo olungaphantsi, olunokukhokelela kwizilonda ezininzi kumanqanaba angekho kufutshane.

Ankylosing Spondylitis

I-Ankylosing spondylitis (AS) isifo esingapheliyo sokuvuvukala kwe-autoimmune isifo esichaphazela ngokukodwa umqolo kwaye sinokukhokelela kwintlungu ebuhlungu engapheliyo evela kwi-spinal fusion.

Enye inkathazo kwizigulane ezine-AS kukuphuhliswa kwesifo se-disc esilinganiselweyo, kwaye kwi-imaging, i-AL inokuhlukaniswa kwi-spondylitis evuthayo ngeziphene ezigxininise kwi-vertebrae enye okanye ezimbini ezikufutshane, ukucutha kwendawo ye-disc, kunye nemimandla ye-sclerosis esebenzayo ejikeleze iziphene ze-osteolytic.

Qaphela: Isigulane esine-spondylitis e-ankylosing, indoda eneminyaka engama-44 ubudala enentlungu engapheliyo ye-back back kunye noluhlu olulinganiselwe lokunyakaza. I-Sagittal ct ye (a) ye-thoracic kunye (b) ne-lumbar spine iifestile zibonisa i-diffus ligamentous syndesmosis ecaleni kwe-longitudinal ligament yangaphambili (iintolo). Kukho kwakhona i-ossification kunye nokudibanisa kwe-lumbar interspinous ligaments (iintolo zibonisiwe). (c) Umfanekiso we-Coronal kwinqanaba le-lumbar spine libonisa ukuxutywa kwezinto ezingasemva kunye ne-articular synovial joints (iintolo).

I-Osteomyelitis Syndrome

I-Acronym SAPHO ibhekisela kwindibaniselwano ye-musculoskeletal and cutaneous manifestations (synovitis, acne, pustulosis, osteomalacia, kunye ne-osteomyelitis), kunye nodonga lwangaphambili lwe-thoracic (kubandakanywa amalungu e-sternoclavicular, i-costothoracic joints, kunye ne-sternoacetabular elbow i-elbow echaphazelekayo kunye ne-lumbar ye-lumbar) Umqolo.Ezona zibonakaliso zixhaphakileyo kwi-x-ray radiographs yi-vertebral body osteolysis kunye okanye ngaphandle kokuwa, kunye ne-osteomalacia kunye ne-ossification ye-paraspinal.I-MRI yeyona nto i-imaging i-MRI yeyona nto i-imaging modality, kwaye ukubonakaliswa kwayo okuphambili kubandakanya utshintsho olubanzi okanye olugxilwe kwi-vertebral ye-vertebral utshintsho kwi-sequences ye-fluid-sensitive sequences kunye ne-intervertebral e-corrections. iidiski ze-intervertebral okanye ii-endplates zangaphambili, kunye ne-edema yezicubu ezithambileyo.

Qaphela: indoda eneminyaka engama-62 ubudala ene-SAPHO syndrome. (a) I-Sagittal t2-weighted and (b) i-computed tomography (CT) imifanekiso ibonisa i-ossification ye-anterior longitudinal ligament (iintolo ezimnyama) Akukho mpazamo ebalulekileyo yediski okanye i-paravertebral fluid. I-L1 ibekwe ngokutsha kakhulu emva kokwaphuka koxinzelelo oludala. (c) I-Axial CT ibonisa i-ankylosis ye-costovertebral joint echanekileyo (i-asterisk). (d) Ukwakhiwa kwakhona kwe-Oblique coronal CT kubonisa i-bilateral thoracic ribcage clavicle ankylosis (iinkwenkwezi ezimnyama). (e) Ukuskena kwamathambo ebonisa ukufunyanwa kwe-radiotracer kumalungu omabini achaphazelekayo (iinkwenkwezi ezimhlophe).

I-Spondyloarthropathy enxulumene ne-Dialysis

I-Dialysis-related spondyloarthropathy (DRS) yinguqu ye-pathologic kwizigulane kwi-hemodialysis yexesha elide. Ixhaphake kakhulu kumqolo womlomo wesibeleko kwaye ngokuqhelekileyo ibonisa ngokunciphisa indawo ye-intervertebral, ukutshatyalaliswa kwe-endplates, ukungabikho kwe-sclerosis, ukubunjwa kwamathambo amatsha, izifo ze-paraspinal / ama-abscesses, kunye nokuqiniswa kwendawo.

Qaphela: I-osteoporosis ebanzi ye-lumbar kunye ne-sacral pelvis. Ukutshatyalaliswa komda we-anterosuperior we-lumbar 5 vertebrae kunye ne-sclerotic hyperplasia yemida (eboniswe lutolo olubomvu). I-hyperplasia yokulimala ekufutshane. Ukutshatyalaliswa kwekhonkco le-sacroiliac lasekhohlo kunye nokutshatyalaliswa kwendawo esecaleni ye-ilium, amathambo amaninzi angaphakathi afile, kunye ne-hyperplasia ye-scar-like tissue hyperplasia (eboniswe ngeentolo eziluhlaza).

Qaphela: Ukuphuculwa kwe-MR: I-Lumbar 4 / 5 i-disc bulge kunye ne-vertebral rim osteophytes, i-hypertrophy ye-ligamentum flavum, ukucutha okuncinci komgudu womgogodla, kunye nokunyanzeliswa komda wangaphambili we-sac dural. Umzimba we-5 vertebral we-lumbar unomda we-concave kwaye unokubonwa njengemicu ye-T1 ende kunye ne-T2 WI i-fat compression high signal, kunye nokuphucula kubonakala emva kokuphucula. Amanqaku amaninzi omqondiso ongaqhelekanga abonwa phantsi kwee-endplates ze-lumbar 5 kunye ne-sacral 1 kunye nangaphantsi kwe-sacroiliac joints, kunye ne-signal ephantsi kwi-T1WI kunye ne-signal encinci kwi-T2WI, kwaye ukuphuculwa kubonakala kwi-scanners yokuphucula (iintolo ezibomvu). Ukuqina kwezicubu ezithambileyo kumda wangaphambili we-vertebrae ye-sacral kwabonwa, kwaye uphuculo lwabonwa kwiskena esiphuculweyo (utolo oluhlaza okwesibhakabhaka). Iimpawu zethambo ze-ilium, i-hip, i-sacrum kunye nentloko ye-femoral kumacala omabini e-pelvis ayizange ibonise ukungaqhelekanga okucacileyo, kwaye iimpawu ze-pelvic zangaphakathi kunye nezangaphandle zaziqhelekileyo, zinezikhewu ezicacileyo ze-muscle kunye nezithuba eziqhelekileyo ezidibeneyo, ngaphandle kweempawu zokwandisa kunye nokunciphisa.

IGout yoMnqonqo

I-Spinal gout ibonakaliswe ngamadiphozithi e-monocrystalline urate crystals (MUCs) kumqolo. I-Spinal gout ichaphazela kakhulu i-lumbar spine. I-radiographs ibonisa ukubonakaliswa okungacacanga kwaye i-CT ibonakalisa ngcono ukhukuliseko lwamathambo kunye nemida ye-sclerotic. iimri zokubonakaliswa azichanekanga.

Qaphela: I-CT scan ecacileyo ibonisa ukucutha kwendawo edibeneyo kunye nokutshatyalaliswa komphezulu we-articular. I-Arthrocentesis iyafuneka ukuqinisekisa ukuxilongwa.

Neurospondylitis

I-spondylitis ye-neurogenic (NS), i-arthropathy eqhubekayo etshabalalisayo, iyenzeka emva kokulahlekelwa yimvakalelo kunye nokufaneleka. Isizathu esixhaphakileyo sisifo esibuhlungu somgogodla, esenza i-70% yamatyala. Ezinye izizathu ziquka isifo sikashukela, isifo se-spinal cord cavernous, kunye nezinye izifo ze-neurologic ezifana ne-peroneal muscular dystrophy kunye ne-Guillain-Barré syndrome. Ngenxa yendima ye-thoracolumbar kunye ne-lumbosacral junctions ekuthwaleni ubunzima, zizona ndawo zixhaphake kakhulu.

Iimpawu eziqhelekileyo ze-NS ziziqhekeza zamathambo, izitenxo ze-intervertebral joint kunye nokungahambelani okukhokelela kwi-vertebral body slippage, ii-endplates ezininzi kunye nokukhukuliseka kwamalungu amancinci kunye nokugcinwa koxinzelelo lwamathambo kwi-sclerosis, kunye nezicubu ezithambileyo.

Qaphela: indoda eneminyaka engama-58 ubudala ene-neuropathic spine. (a) I-Sagittal kunye (b) i-coronal computed tomographic reconstructions ibonisa ii-endplates ezininzi ze-lumbar vertebral kunye ne-articular synovial joint erosions (iintolo) ezinamaqhekeza amathambo. Ukutshatyalaliswa kweyunithi ye-L2-L3 ye-intervertebral disc kunye nokwandiswa kwendawo ye-intervertebral (asterisk). (c) I-Sagittal kunye (d) i-axial t2-weighted magnetic resonance sequences eqinisekisa ukwanda kwe-L2-L3 intervertebral space. utshintsho oluphawulekayo lwe-spinal cord echaphazelekayo emva kwe-L2-L3-L4. Kukho kwakhona ukutshatyalaliswa kwizicubu ezithambileyo emva nangaphambili kwiinkqubo ze-spinous (asterisks).