The MRI appearances of early vertebral osteomyelitis and discitis

Dunbar, Jane; Sandoe, Jonathan; Rao, Abhay; Crimmins, Darach; Baig, Wazir; Rankine, James J.

doi:10.1016/j.crad.2010.03.015

Cited by 97 publications

(53 citation statements)

References 13 publications

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“…Routine use of follow-up MRI in patients who have clinical response to therapy is not supported by Kowalski et al 21 . We agree with Dunbar et al that follow-up MRI 2-3 weeks after initial MRI seems reasonable in cases where there is clinical evidence for spinal infection but the initial MRI is negative or inconclusive 22 . Instead of follow-up MRI, follow-up measurements of ESR and CRP may be useful to determine the response to antibiotic or surgical treatment.…”

Section: Discussionsupporting

confidence: 47%

Vertebral Osteomyelitis in Adult Patients – Characteristics and Outcome

Mustapić

Višković

Borić³

et al. 2016

ACC

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SUMMARY -The aim of the study was to assess disease characteristics and outcome in patients with vertebral osteomyelitis (VO). A two medical centre retrospective cohort study was performed by chart review after discharge of 110 patients with confirmed VO treated during a 5-year period. Patients were divided in two groups: patients with uncomplicated VO and patients with complicated VO. All patients underwent clinical and biological examinations and magnetic resonance imaging (MRI) according to the same protocol. Patients with complicated VO were significantly older (p=0.038). They were longer treated with antibiotics parenterally (p=0.047) and more often surgically (p<0.001). In these patients, high Charlson comorbidity index (CCI) score was more often observed (p=0.024), as well as liver cirrhosis (p=0.013) and degenerative spine disease (p=0.007) as comorbidities. Patients with advanced MRI changes of VO had a modified CCI score of 2 or more (p=0.006). They more often experienced neurological deficit (p=0.021). Staphylococcus aureus was the most frequently isolated bacterium from blood and tissue samples. Advanced MRI changes and complicated VO were more often observed in patients with high CCI score due to impaired immune system caused by chronic comorbid disease(s) or modulation of immunity with medications. High CCI scores were more frequently associated with positive blood cultures due to bacteremia because of impaired immunity. Patients with complicated VO were longer treated with antibiotics parenterally and more often surgically treated for phlegmon and abscess formation. Liver cirrhosis and degenerative spine disease, which were more often found in patients with complicated VO, obviously impacted the course of the disease.

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Section: Discussionsupporting

confidence: 47%

Vertebral Osteomyelitis in Adult Patients – Characteristics and Outcome

Mustapić

Višković

Borić³

et al. 2016

ACC

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“…[3][4][5][6][7][8][9][10][11][12][13] Modic type 1 degenerative signal changes on conventional MR imaging sequences can mimic or suggest infection, leading to additional costly and sometimes invasive investigations. [14][15][16][17] This study assesses the utility of a specific pattern of diffusion abnormality, the "claw sign," for confirming the presence of true degenerative endplate changes and reducing concern for possible vertebral diskitis/osteomyelitis.…”

mentioning

confidence: 99%

Diffusion-Weighted MRI "Claw Sign" Improves Differentiation of Infectious from Degenerative Modic Type 1 Signal Changes of the Spine

Patel

Poplawski

Pawha

et al. 2014

American Journal of Neuroradiology

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“…13 Specifically, epidural abscess and phlegmon have known associations with spinal infections. 22,24 To our knowledge, this is first study to evaluate the MR imaging appearance of the psoas musculature, specifically as an indicator of lumbar DOM. Psoas abscess has been associated with a spinal source of infection 25,26 but often occurs as a late presentation of disease.…”

Section: 22mentioning

confidence: 99%