Diagnosis of Vertebral Osteomyelitis in a Community Hospital by Using Computed Tomography

Abbey, David M.; Hosea, Stephen W.

doi:10.1001/archinte.1989.00390090083017

Cited by 12 publications

(2 citation statements)

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“…Few scientific studies about MDCT have achieved a higher sensitivity than ours [ 14 , 15 , 19 ]. However, it seems unlikely that modern MDCT has lower sensitivity than older CT scanners in identifying and evaluating spondylodiscitis [ 26 ].…”

Section: Discussionmentioning

confidence: 73%

“…It allows the identification of spine pathologies such as fractures, which could be a plausible differential diagnosis in a patient with non-specific clinical manifestations [ 10 , 11 , 12 , 13 ]. The number of published studies on the diagnostic accuracy of CT in the depiction of suspected spondylodiscitis is scant, and most of these studies have been conducted with older generation CT scanners [ 14 , 15 ]. Now, thin-slice multi-detector CT (MDCT) scanners allow images characterized by high spatial and contrast resolution and with high detail multiplanes reconstructions to be obtained.…”

Section: Introductionmentioning

confidence: 99%

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The Diagnostic Performance of Multi-Detector Computed Tomography (MDCT) in Depiction of Acute Spondylodiscitis in an Emergency Department

Negro¹,

Somma²,

Tortora³

et al. 2022

Tomography

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Background: The diagnosis of acute spondylodiscitis can be very difficult because clinical onset symptoms are highly variable. The reference examination is MRI, but very often the first diagnostic investigation performed is CT, given its high availability in the acute setting. CT allows rapid evaluation of other alternative diagnoses (e.g., fractures), but scarce literature is available to evaluate the accuracy of CT, and in particular of multi-detector computed tomography (MDCT), in the diagnosis of suspected spondylodiscitis. The aim of our study was to establish MDCT accuracy and how this diagnostic method could help doctors in the depiction of acute spondylodiscitis in an emergency situation by comparing the diagnostic performance of MDCT with MRI, which is the gold standard. Methods: We searched our radiological archive for all MRI examinations of patients who had been studied for a suspicion of acute spondylodiscitis in the period between January 2017 and January 2021 (n = 162). We included only patients who had undergone MDCT examination prior to MRI examination (n = 25). The overall diagnostic value of MDCT was estimated, using MRI as the gold standard. In particular, the aim of our study was to clarify the effectiveness of CT in radiological cases that require immediate intervention (stage of complications). Therefore, the radiologist, faced with a negative CT finding, can suggest an elective (not urgent) MRI with relative serenity and without therapeutic delays. Results: MDCT allowed identification of the presence of acute spondylodiscitis in 13 of 25 patients. Specificity and positive predictive value were 100% for MDCT, while sensitivity and negative predictive value were 68% and 50%, respectively, achieving an overall accuracy of 76%. In addition, MDCT allowed the identification of paravertebral abscesses (92%), fairly pathognomonic lesions of spondylodiscitis pathology. Conclusions: The MDCT allows identification of the presence of acute spondylodiscitis in the Emergency Department (ED) with a satisfactory accuracy. In the case of a positive CT examination, this allows therapy to be started immediately and reduces complications. However, we suggest performing an elective MRI examination in negative cases in which pathological findings are hard to diagnose with CT alone.

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Section: Discussionmentioning

confidence: 73%