Qual o seu diagnóstico?

Daher, Sérgio; Júnior, Wilson Eloy Pimenta; Júnior, Zeno Augusto de Souza; Machado, Márcio Martins; Rosa, Ana Cláudia Ferreira; Teixeira, Kim-Ir-Sen Santos; Daher, Murilo Tavares; Daher, Renato Tavares

doi:10.1590/s0100-39842004000100002

Cited by 2 publications

(2 citation statements)

References 26 publications

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“…Magnetic resonance imaging (MRI) is the method of choice because of its high sensitivity and specificity (14) , as well as good tissue resolution and multiplanar capacity (15) . Also, MRI can be useful to suggest the origin of the infection -although this is not always possible -, aiding in the differentiation between tuberculous and pyogenic infections, thus allowing efficacy in the treatment of the patient (16) . Main MRI findings include hyposignal on T1-weighted and hypersignal on T2-weighted images from the vertebral bodies and adjacent intervertebral discs, as well as enhancement after intravenous paramagnetic contrast medium injection, besides paravertebral masses/abscesses, all of them nonspecific (17) .…”

Section: Introductionmentioning

confidence: 99%

Pyogenic and tuberculous discitis: magnetic resonance imaging findings for differential diagnosis

et al. 2013

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Spondylodiscitis represents 2%-4% of all bone infections cases. The correct diagnosis and appropriate treatment can prevent complications such as vertebral collapse and spinal cord compression, avoiding surgical procedures. The diagnosis is based on characteristic clinical and radiographic findings and confirmed by blood culture and biopsy of the disc or the vertebra. The present study was developed with Clementino Fraga Filho University Hospital patients with histopathologically and microbiologically confirmed diagnosis of spondylodiscitis, submitted to magnetic resonance imaging of the affected regions. In most cases, pyogenic spondylodiscitis affects the lumbar spine. The following findings are suggestive of the diagnosis: segmental involvement; ill-defined abscesses; early intervertebral disc involvement; homogeneous vertebral bodies and intervertebral discs involvement. Tuberculous spondylodiscitis affects preferentially the thoracic spine. Most suggestive signs include: presence of well-defined and thin-walled abscess; multisegmental, subligamentous involvement; heterogeneous involvement of vertebral bodies; and relative sparing of intervertebral discs. The present pictorial essay is aimed at showing the main magnetic resonance imaging findings of pyogenic and tuberculous discitis. Keywords: Magnetic resonance imaging; Discitis; Intervertebral disc; Spinal tuberculosis.Espondilodiscites representam 2%-4% de todos os casos de infecções no esqueleto. Seu rápido diagnóstico e tratamento apropriado podem evitar complicações, tais como colapsos vertebrais, compressão medular, evitando a realização de procedimentos cirúrgicos. Seu diagnóstico é baseado em achados clínicos e radiológicos característicos, sendo confirmado por hemoculturas, biópsia do disco ou da vértebra. Este estudo foi realizado com pacientes do Hospital Universitário Clementino Fraga Filho que tiveram o diagnóstico histopatológico ou microbiológico comprovado de espondilodiscite e realizaram ressonância magnética das regiões acometidas. Espondilodiscites piogênicas acometem preferencialmente a coluna lombar. Os principais sinais sugestivos são: acometimento segmentar; abscessos de limites pouco definidos; acometimento precoce do disco intervertebral; acometimento homogêneo dos corpos vertebrais e discos intervertebrais. A espondilodiscite tuberculosa afeta preferencialmente os segmentos vertebrais torácicos. As imagens mais sugestivas são: abscesso de paredes delgadas e bem definidas; envolvimento subligamentar multissegmentar; acometimento heterogêneo dos corpos vertebrais; discos intervertebrais relativamente poupados. O objetivo deste ensaio iconográfico é apresentar os principais aspectos das espondilodiscites piogênica e tuberculosa nas imagens por ressonância magnética. Unitermos: Ressonância magnética; Discite; Disco intervertebral; Tuberculose da coluna vertebral. AbstractResumo * Study developed in the

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Section: Introductionmentioning

confidence: 99%

Pyogenic and tuberculous discitis: magnetic resonance imaging findings for differential diagnosis

et al. 2013

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“…Magnetic resonance is the most sensitive and most specific method for differentiating the nature of the vertebral collapses, in addition to showing early alterations (9,18,19) that aid in diagnosing tuberculous spondylitis (20) . However, it may produce similar imaging results in cases of vertebral neoplasia and infection by pyogenic bacteria (9,21) .…”

Section: Discussionmentioning

confidence: 99%

Espondilite tuberculosa em adolescente

Cabral¹,

Azevedo²,

Montenegro³

et al. 2005

J. bras. pneumol.

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Relata-se o caso de uma adolescente com tuberculose osteoarticular em coluna lombossacral, uma localização incomum. O seu diagnóstico permanece um desafio por apresentar sintomas gerais inespecíficos e lesões ósseas que podem ser confundidas com outras afecções. A doença é degenerativa e de prognóstico reservado. São discutidos aspectos clínicos, laboratoriais e de imagem, incluindo tomografia computadorizada e ressonância magnética. A reação em cadeia da polimerase, usando o marcador IS 6110 para M. tuberculosis, foi positiva, sugerindo fortemente a presença do patógeno. Este ensaio é particularmente indicado quando se exige um diagnóstico de tuberculose rápido e sensível.

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Qual o seu diagnóstico?

Cited by 2 publications

References 26 publications

Pyogenic and tuberculous discitis: magnetic resonance imaging findings for differential diagnosis

Pyogenic and tuberculous discitis: magnetic resonance imaging findings for differential diagnosis

Espondilite tuberculosa em adolescente

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