Differentiation between Tuberculous Spondylitis and Pyogenic Spondylitis on MR Imaging

Park, Jong Han; Shin, Hye Seon; Kim, Tae Young; Eom, Ki‐Seong

doi:10.14245/kjs.2011.8.4.283

Cited by 10 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Proteolytic enzymes absence is the cause of sub ligamentous spread of infection in Tb spondylodiscitis. Sub ligamentous spread to multiple vertebral bodies is common in TB Spondylodiscitis [22,23] . Infection spreads from anterior lesion of body of vertebra behind anterior longitudinal ligament to adjacent IV disc and vertebral body.…”

Section: Discussionmentioning

confidence: 99%

Role of MRI imaging in tuberculous and pyogenic spondylodiscitis

R¹,

SH²,

Bhanuprakash³

et al. 2023

Int. J. Radiol. Diagn. Imaging

View full text Add to dashboard Cite

Background: MRI has advantage in the diagnosis of spinal infections because of its multiplanar capabilities, soft tissue contrast resolution and delineates extent of disease. The purpose of our study is to identify differences in MR imaging between pyogenic and TB Spondylodiscitis. Methods and Materials: Retrospective analysis of MR Images of 72 patients with confirmed Spondylodiscitis (47 patients with TB Spondylodiscitis and 25 patients with pyogenic Spondylodiscitis). T2, STIR, T1 weighted images (with and without contrast enhancement) were assessed in axial, sagittal and coronal planes. Statistical analysis is by Chi-square test and p value. Result: The main suggestive findings for TB Spondylodiscitis are a) Thin and smooth abscess wall (80.9% TB Spondylodiscitis vs. 4% pyogenic Spondylodiscitis). b) Well defined paraspinal abnormal signal (83% vs. 16%) c) Heterogeneous and focal enhancement of vertebral body (91.5% vs. 8%) d) D) Multi segmental involvement (61.7% vs. 38.3%). The main suggestive findings for Pyogenic Spondylodiscitis are a) Thick and irregular abscess wall (56% in Pyogenic Spondylodiscitis vs. 4.2% in TB Spondylodiscitis). b) Ill-defined paraspinal abnormal signal (76% vs. 8.5%) c) Homogenous and diffuse enhancement of vertebral body (92.0% vs. 8.5%) d) D) Segmental involvement (68% vs. 38.3%) e) E) Disc space narrowing (100% vs.74.5%) Conclusion: Thus MR imaging can differentiate Pyogenic Spondylodiscitis from TB Spondylodiscitis.

show abstract

Section: Discussionmentioning

confidence: 99%

Role of MRI imaging in tuberculous and pyogenic spondylodiscitis

R¹,

SH²,

Bhanuprakash³

et al. 2023

Int. J. Radiol. Diagn. Imaging

View full text Add to dashboard Cite

show abstract

“…The onset of symptoms is commonly insidious, with spinal pain being the most common presenting complaint. Although more than 90% of cases are pyogenic [6,9], fever is typically not present and occurs in less than 20% of patients [6,13].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic-Induced Increase in Inflammatory Markers in Cured Infectious Spondylitis : Two Case Reports

Eom

2019

J Korean Neurosurg Soc

Self Cite

View full text Add to dashboard Cite

Conservative therapy with appropriate antibiotics is essential for most patients with infectious spondylitis. Although most antibiotics do not cause problems if it used properly and serious side effects are rare, side effects can occur with any class of drugs and adverse reactions of antibiotics can range from mild allergic reactions to serious and fulminant adverse events. These side effects are also extremely variable from patient to patient and from antibiotic to antibiotic. A side effect of antibiotics may paradoxically increase inflammatory marker levels. Here, the author presents two cases of antibiotic-induced increase in inflammatory markers in cured infectious spondylitis. The patients were successfully treated after stopping the antibiotic therapy. The differential diagnosis between antibiotic side effects and infection should be considered very carefully because the treatment is completely different. Although the exact mechanisms underlying successful treatment without antibiotics are unclear, we should consider the side effects of antibiotics when following inflammatory markers during treatment of infectious spondylitis.

show abstract

“…Bei Tuberkulose (TB) treten Psoasabszesse und paravertebrale Abszesse häufiger auf [35]. Ebenso imponieren bei TB-Patienten oft kyphotische Deformitäten und Anschwellungen [36].…”

Section: Klinische Diagnostikunclassified

Spondylitis – Spondylodiscitis – an Update

et al. 2018

View full text Add to dashboard Cite

Spondylodiscitis is an infection of the intervertebral disc with subsequent infection of the adjacent vertebral bodies. The main causes are 3 pathogen groups: bacteria, particularly tuberculosis pathogens, fungi and parasites. In pyogenic spondylodiscitis, infections with Staphylococcus aureus are the most common, with an incidence of up to 80%. Mortality is around 2 - 3%. Infections with tuberculosis are often associated with psoas and paravertebral abscesses. Neurological deficits are registered in up to 50% of patients. For microbiological diagnostic testing, blood cultures are used for aerobic and anaerobic bacteria. However, histological examination leads significantly more frequently to positive pathogen detection. In tissue samples, results with 16S rRNA PCR results are clearly superior to results from microbiological examination. The MRI exhibits high sensitivity and specificity and is therefore superior to other radiological methods. Elimination of the infection, pain reduction and stabilisation of the spine are the main objectives of any treatment. A standardised antibiotic therapy for spondylodiscitis has not been clearly defined. Pathogen detection is important, with focused antibiotic therapy. Antibiotic therapy should initially be administered intravenously for 2 - 4 weeks. This should be followed by oral administration for 6 - 12 weeks. In the case of antibiotic-resistant infections with neurological deficiencies, it is recommended to perform a surgical procedure, with careful debridement and instrumentation as well as i. v. administered antibiotics for 3 weeks followed by three month oral antibiotic treatment. Surgical procedures are indicated with neurological deficits, progressive increase in spinal deformities, failure of conservative therapy with insufficient pain relief and unreliable pathogen identification. The selection of the surgical procedure should mainly be based on the extent and localisation of bone destruction and the individual circumstances of the patients. The prognosis is good if there is a clear reduction in CRP and ESR in the first few weeks.

show abstract

Differentiation between Tuberculous Spondylitis and Pyogenic Spondylitis on MR Imaging

Cited by 10 publications

References 18 publications

Role of MRI imaging in tuberculous and pyogenic spondylodiscitis

Role of MRI imaging in tuberculous and pyogenic spondylodiscitis

Antibiotic-Induced Increase in Inflammatory Markers in Cured Infectious Spondylitis : Two Case Reports

Spondylitis – Spondylodiscitis – an Update

Contact Info

Product

Resources

About