Abstract:Destructive spondyloarthropathy has recently been described in patients who undergo maintenance hemodialysis for chronic renal disease. The condition most frequently involves the lower segment of the cervical spine, although the craniocervical junction also may be affected. Although the pathogenesis of destructive spondyloarthropathy remains unclear, the disorder is thought to relate to a hemodialysis-associated amyloidosis. It appears that the disease correlates with the duration of hemodialysis, although it … Show more
“…13). Although MR imaging appearances can be similar to those of infection, these patients are usually clinically silent and bone marrow edema is not as prominent as infection [33]. Differentiation between infectious spondylodiscitis and amyloid spondylopathy can be achieved by biopsy, with negative culture and positive stain for amyloid.Fig.…”
Section: Imaging Features Of Pathologies Mimicking Spinal Infectionsmentioning
Magnetic resonance (MR) imaging plays an important role in the evaluation of bacterial and tuberculous spondylodiscitis and associated complications. Owing to its high sensitivity and specificity, it is a powerful diagnostic tool in the early diagnosis of ongoing infections, and thus provides help in prompt initiation of appropriate, therapy which may be medical or surgical, by defining the extent of involvement and detection of complications such as epidural and paraspinal abscesses. More specifically, MR imaging helps in differentiating bacterial from tuberculous infections and enables follow up of progression or resolution after appropriate treatment. However, other non-infectious pathology can demonstrate similar MR imaging appearances and one should be aware of these potential mimickers when interpreting MR images. Radiologists and other clinicians need to be aware of these potential mimics, which include such pathologies as Modic type I degenerative changes, trauma, metastatic disease and amyloidosis. In this pictorial review, we will describe and illustrate imaging findings of bacterial and tuberculous spondylodiscitis, their complications and non-infectious pathologies that mimic these spinal infections.
“…13). Although MR imaging appearances can be similar to those of infection, these patients are usually clinically silent and bone marrow edema is not as prominent as infection [33]. Differentiation between infectious spondylodiscitis and amyloid spondylopathy can be achieved by biopsy, with negative culture and positive stain for amyloid.Fig.…”
Section: Imaging Features Of Pathologies Mimicking Spinal Infectionsmentioning
Magnetic resonance (MR) imaging plays an important role in the evaluation of bacterial and tuberculous spondylodiscitis and associated complications. Owing to its high sensitivity and specificity, it is a powerful diagnostic tool in the early diagnosis of ongoing infections, and thus provides help in prompt initiation of appropriate, therapy which may be medical or surgical, by defining the extent of involvement and detection of complications such as epidural and paraspinal abscesses. More specifically, MR imaging helps in differentiating bacterial from tuberculous infections and enables follow up of progression or resolution after appropriate treatment. However, other non-infectious pathology can demonstrate similar MR imaging appearances and one should be aware of these potential mimickers when interpreting MR images. Radiologists and other clinicians need to be aware of these potential mimics, which include such pathologies as Modic type I degenerative changes, trauma, metastatic disease and amyloidosis. In this pictorial review, we will describe and illustrate imaging findings of bacterial and tuberculous spondylodiscitis, their complications and non-infectious pathologies that mimic these spinal infections.
“…HRS may also produce a soft-tissue mass that contains crystals with calcification or amyloid resulting in epidural thickening and canal stenosis [4].…”
“…Radiographically, and occasionally clinically, DSA may mimic infective spondyloarthropathy. 1 This is particularly so because, as demonstrated in this case report, destructive progressively can result in rapid progressive intervertebral disc and vertebral body destruction. This rapid radiographic deterioration has not been previously illustrated.…”
Study Design. A case of destructive spondyloarthropathy was reported.Objectives. To describe the rapid destruction of intervertebral disc and vertebral body as a consequence of destructive spondyloarthropathy in a patients with endstage renal disease receiving hemodialysis.Summary of Background Data. An important facet of this case is that the serial radiographs provide key information about the rapid nature of dialysis associated destructive spondyloarthropathy, a condition which has been increasingly recognized over the last 2 decades.Methods. The clinical and radiologic features of a 55-year-old dialysis patient with destructive spondyloarthropathy are herein detailed. Her serial radiographs and magnetic resonance images have implications both for our understanding of the underlying destructive process and its clinical evaluation.Results. Serial lateral lumbar spines illustrated that the destructive process started at the leading edge of the endplate of vertebral body, closely followed by adjacent intervertebral disc destruction that appeared in parallel with vertebral body bone resorption.Conclusions. A case of dialysis-associated destructive spondyloarthropathy was reported, with key information about its rapid nature being provided by serial radiographs.
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