Imaging Psoas Sign in Lumbar Spinal Infections: Evaluation of Diagnostic Accuracy and Comparison with Established Imaging Characteristics

Ledbetter, Luke N.; Salzman, Karen L.; Shah, Lubdha M.

doi:10.3174/ajnr.a4571

Cited by 31 publications

(17 citation statements)

References 31 publications

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“…Owing to its high sensitivity and specificity of up to 90% or greater [1–5], it is a powerful diagnostic tool in the early diagnosis of spondylodiscitis. MR imaging 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.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging of bacterial and tuberculous spondylodiscitis with associated complications and non-infectious spinal pathology mimicking infections: a pictorial review

Kumar

Gupta

Chhabra

et al. 2017

BMC Musculoskelet Disord

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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.

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Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging of bacterial and tuberculous spondylodiscitis with associated complications and non-infectious spinal pathology mimicking infections: a pictorial review

Kumar

Gupta

Chhabra

et al. 2017

BMC Musculoskelet Disord

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“…We propose that MRI signal changes, as STIR or T2-weighted hyperintensity, of the LCM without calcification of the tendon could represent a potentially important sign suggestive of pyogenic inflammation in cervical spinal infections, including cervical discitis-osteomyelitis. Ledbetter et al recently reported that psoas T2 hyperintensity, as the imaging psoas sign, correlates closely with discitis-osteomyelitis [ 7 ]. LCM hyperintensity without tendon calcification in the cervical region might have diagnostic value similar to psoas T2 hyperintensity in the lumbar region.…”

Section: Discussionmentioning

confidence: 99%

MR T2 high image of longus colli muscle without tendinous calcification; A suggestive sign of cervical spinal infection

et al. 2018

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“…There are no reports specifically addressing the question of whether a 1.5 Tesla magnet is the minimum required for the diagnosis of SD. However, the vast majority of authors of published papers performed MRI using 1.5 T or higher magnet [55,110,161,162].…”

Section: Level Of Evidence:mentioning

confidence: 99%

Joint EANM/ESNR and ESCMID-endorsed consensus document for the diagnosis of spine infection (spondylodiscitis) in adults

Lazzeri

Bozzao

Cataldo

et al. 2019

Eur J Nucl Med Mol Imaging

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Purpose Diagnosis of spondylodiscitis (SD) may be challenging due to the nonspecific clinical and laboratory findings and the need to perform various diagnostic tests including serologic, imaging, and microbiological examinations. Homogeneous management of SD diagnosis through international, multidisciplinary guidance would improve the sensitivity of diagnosis and lead to better patient outcome. Methods An expert specialist team, comprising nuclear medicine physicians appointed by the European Association of Nuclear Medicine (EANM), neuroradiologists appointed by the European Society of Neuroradiology (ESNR), and infectious diseases specialists appointed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), reviewed the literature from January 2006 to December 2015 and proposed 20 consensus statements in answer to clinical questions regarding SD diagnosis. The statements were graded by level of evidence level according to the 2011 Oxford Centre for Evidence-based Medicine criteria and included in this consensus document for the diagnosis of SD in adults. The consensus statements are the result of literature review according to PICO (P:population/patients, I:intervention/indicator, C:comparator/control, O:outcome) criteria. Evidence-based recommendations on the management of adult patients with SD, with particular attention to radiologic and nuclear medicine diagnosis, were proposed after a systematic review of the literature in the areas of nuclear medicine, radiology, infectious diseases, and microbiology. Results A diagnostic flow chart was developed based on the 20 consensus statements, scored by level of evidence according to the Oxford Centre for Evidence-based Medicine criteria. Conclusions This consensus document was developed with a final diagnostic flow chart for SD diagnosis as an aid for professionals in many fields, especially nuclear medicine physicians, radiologists, and orthopaedic and infectious diseases specialists.

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Imaging Psoas Sign in Lumbar Spinal Infections: Evaluation of Diagnostic Accuracy and Comparison with Established Imaging Characteristics

Cited by 31 publications

References 31 publications

Magnetic resonance imaging of bacterial and tuberculous spondylodiscitis with associated complications and non-infectious spinal pathology mimicking infections: a pictorial review

Magnetic resonance imaging of bacterial and tuberculous spondylodiscitis with associated complications and non-infectious spinal pathology mimicking infections: a pictorial review

MR T2 high image of longus colli muscle without tendinous calcification; A suggestive sign of cervical spinal infection

Joint EANM/ESNR and ESCMID-endorsed consensus document for the diagnosis of spine infection (spondylodiscitis) in adults

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