Osteoarticular Involvement among 202 Brucellosis Cases Identified in Central Anatolia Region of Turkey

Abstract

Objective The musculoskeletal system is one of the most commonly affected systems in brucellosis. The objective of this study was to determine the frequency, types, and clinical features of osteoarticular involvement among cases with brucellosis in the Central Anatolia region of Turkey and to establish the differences between patients with and without osteoarticular involvement. Methods Included in this study were 202 patients with Brucellosis presented between June 2003 and June 2009. The diagnosis of osteoarticular system complications was established by physical examination and radiological findings obtained by diagnostic imaging tools. Magnetic resonance images of thoracic, lumbar or sacral vertebrae were acquired from patients with back pain, low back pain and sacro-iliac joint pain. Results Osteoarticular involvement was noted in 94 patients (46.5%). The most common sources of infection are employment in farming and/or consumption of un-pasteurized milk or dairy products, especially fresh cheese in 53 (75.7%) cases. The mean age is 46.7±18 years. Sacroiliitis is the most frequent osteoarticular involvement (60.6%), 82.4% of which is bilateral. Sacroiliitis was followed by spondylodiscitis in 36 (38.3%), peripheral arthritis in 15 (16%), bursitis in 1(1.1%) case. Patients with osteoarticular involvement received medical treatment for at least three months. Conclusion The ratio and anatomical region of osteoarticular involvement in brucellosis show variability among countries. In this study, it is demonstrated that sacroiliitis is the most common form of osteoarticular involvement in the Central Anatolia region of Turkey. In endemic countries such as Turkey, this disease should be included in the differential diagnosis for patients with symptoms of sacroiliitis, spondylodiscitis or those with articular pain.

An old foe still with us: Troubling issues with brucellosis

“…The most common complication of the disease is bone and joint involvement (20%-85%) (2,8). The most common clinical forms of osteoarticular involvement are arthritis, spondylitis, bursitis, tenosynovitis, and osteomyelitis.…”

A Case of Brucellosis with Olecranon Bursitis, Spondylodiscitis and Epididymo-orchitis

“…Türkiye'de farklı merkezlerden brusellozun osteoartiküler tutulum bulgularının araştırıldığı çalışmalarda bursit rastlanma oranları sırasıyla %1.1, %4.6, %5.7, %4.7 ve %2.8 olarak bulunmuştur (4,9,10,13,16). Genellikle diğer osteoartiküler sistem bulgularına bursit eşlik etmektedir.…”

“…Genitoüriner sistem tutulumu ise %2-10 oranında görülür. En sık izlenen genitoüriner komplikasyon akut epididimoorşittir (4,5).…”

A Case of Spondylodiscitis with Spinal Prevertebral Abscess due to Brusellozis

“…But serological tests are used more often to diagnose because of difficulty and wanting long period to culture (3). In addition, involvement of gastrointestinal tract, central nervous system and genitourinary system is frequently seen (4,5). The aim of this study is to define a case of brucellosis which presented with spondylodiscitis and an abscess in paravertebral region with a difficult diagnosis and treatment.…”