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At least 1,063 records · Page 59Linked to original sources
PubMed1990

Disc space infection: a case report with MRI diagnosis.

Vertebral disc space infection is an uncommon cause of back pain. Physical findings may be unimpressive and laboratory evaluation may only disclose an elevated erythrocyte sedimentation rate. Magnetic resonance imaging is particularly useful, since it reveals abnormalities earlier than plain radiographs and is more precise than bone scan.

Back Pain↗
PubMed1990

[Surgery for backache].

All types of lumbar pain are of course not an indication for surgery. However, an operation may bring relief from lymbodynia in given conditions, owing to the better knowledge of spinal physiopathology and to the evolution of the surgical technique. This is the case for intervertebral disk pathology, lesions of the posterior articular structures, lumbar canal stenosis, vertebral tumors or malunions, as well as for some cases of painful frontal or sagittal deviation of the spine. State-of-the art techniques utilize arthrodesis, often with a plate or CD-material osteosynthesis, but future surgery should be aimed at preserving motion.

Back Pain↗
PubMed1990

[Infection by the hematogenic route of closed vertebral fracture: apropos of a case and review of the literature].

We report a new case of haematogenous infection at the site of a spinal fracture. The patient developed a severe bronchopneumonial infection. After the trauma three weeks later he developed a severe but incomplete cord lesion due to acute vertebral osteomyelitis. The patient was treated with antibiotics. He made a slow, but uneventful and complete neurological recovery. 28 instances of osteomyelitis after fracture of which seven involved vertebral bones have been previously reported. The spontaneous appearance of haematogenous osteomyelitis in a fractured bone is a rare but not exceptional event.

Bacterial Infections↗
PubMed1990

[Intrathoracic Pott's abscesses, radiologic pitfalls for the pneumologist].

The authors have conducted a retrospective study of 200 cases of tuberculous spondylitis, and wish to draw attention to the clinical and, chiefly, radiological aspects of the disease. Intrathoracic Pott's abscesses are principally observed in developing countries but they are not exceptional in France, and their varied semeiology deserves to be described.

Adolescent↗
PubMed1990

[Magnetic resonance in the diagnosis of bone infections].

Skeletal infections represent a variety of clinical and pathological conditions in which both an early diagnosis and the precise evaluation of disease extent are very important in planning proper therapy. To determine MRI capabilities and limitations in the evaluation of skeletal infections 21 patients--12 with a clinical diagnosis of osteomyelitis of the lower limbs and 9 with a clinical diagnosis of spondyloscitis--were studied with this technique. All patients were examined with conventional X-rays; conventional tomography was performed in 3 cases, and CT in 6. Signal intensities and morphological aspects were then evaluated with MRI. MRI diagnoses were compared with surgical findings or clinical follow-up, after antibiotic therapy: 19 true-positives were observed, together with 1 true-negative, 1 false-positive, and no false-negatives. MRI findings were correlated with those of conventional radiology: MRI identified the lesions and their nature in 100% of cases, whereas conventional radiology did the same in 85% of cases; in 50% of cases only the latter was able to define the nature of the process. Four patients underwent MRI follow-up. MRI was highly sensitive in determining the presence of lesions in an early stage and in demonstrating lesion regression. Moreover, MRI was able to identify the complications occurring in some cases of osteomyelitis and spondyloscitis. In all cases MRI allowed the extent of the disease to be accurately determined and, in osteomyelitis of the lower limbs, it was extremely useful to differentiate soft-tissue infections from bone marrow involvement.

Adolescent↗
PubMed1990

Septic Streptococcus milleri spondylodiscitis.

We describe 2 patients presenting lumbar spondylitis due to Streptococcus milleri. In both cases origin was related to preexistent intestinal pathology. Surgical drainage of a collection of pus was necessary in one case. Longterm antibiotic therapy led to full recovery. Despite confused nomenclature Streptococcus milleri must be considered a serious pathogen mainly associated with purulent infection with osteoarticular affinity.

Abscess↗
PubMed1990

[Immunoscintigraphy for the detection of inflammation foci in bone and joint diseases].

We evaluated the monoclonal antibody MAb, BW 250/183, which is easy to label with Tc-99m, with respect to its clinical application for the detection of inflammatory processes in bone and joint diseases. This monoclonal antibody is a murine immunoglobulin (IgG1 isotype), directed against NCA 95 (nonspecific cross-reacting antigen), which is also present on the surface of neutrophil granulocytes. We investigated patients with acute (n = 9) and chronic (n = 3) osteomyelitis, with coxitis (n = 3) and coxarthrosis (n = 2), with septic hip prosthesis (n = 8) and loosening hip prosthesis (n = 14), with low back pain (n = 4), with spondylitis (n = 5) and with postoperative spondylodiscitis (n = 9). With reference to the total number of patients examined in this study we found 29 true positive results, 22 true negative results, 4 false negative results and 2 false positive results. This gives a sensitivity of 88% and a specificity of 92%. The lesions were already visualized within 4 to 6 hours, but 24 hour pictures are desirable. SPECT pictures are mandatory in patients with diseases of the hip or of the spine because sensitivity is considerably improved thereby.

Adolescent↗
PubMed1990

Scintigraphic detection of bone and joint infections with indium-111-labeled nonspecific polyclonal human immunoglobulin G.

The utility of indium-111-(111In) labeled immunoglobulin G (IgG) to detect infection of bone and adjacent tissues was investigated. Proof of infection was obtained by cultures taken at surgery. All 32 patients showed focally increased uptake on the technetium-99m- (99mTc) methylene diphosphonate (MDP) skeletal scintigraphies. Labeled immunoglobulin correctly identified presence, location, extent and soft-tissue involvement of the suspected inflammatory site. In these patients, focally increasing accumulation was noted over 48 hr. Discrimination between infection and sterile inflammatory lesions was not possible. Two fractures, 6-mo-old, and an aseptic loosening of a total-hip prosthesis were not visualized. Side effects after the immunoglobulin administration were not observed. Radiolabeled immunoglobulin is a new and safe radiopharmaceutical for the investigation of infectious bone and joint disease. The sensitivity of this agent appears at least as high as that of labeled leukocytes. However, labeled immunoglobulin can easily be prepared in every nuclear medicine department.

Arthritis, Infectious↗