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Infectious spondylitis

Uwe H W Schütz
BACKGROUND: Radiological imaging is important in the preoperative diagnosis of many forms of spinal pathology and plays a fundamental role in the assessment of p.o. effects, which can be verified on the spinal column as well as on the surrounding soft tissues, depending on the imaging method used. AIM: The article provides an overview of the current status and possibilities of radiological diagnostic methods for the verification of possibly recommended spine surgery in the context of degenerative, inflammatory-infectious, post-traumatic or p...
January 17, 2019: Der Orthopäde
Giuseppe Lopalco, Vincenzo Venerito, Jurgen Sota, Donato Rigante, Silvana Guerriero, Ida Orlando, Rossella Franceschini, Rossella Favale, Giovanni Lapadula, Barbara Castelli, Bruno Frediani, Mauro Galeazzi, Francesco La Torre, Florenzo Iannone, Gian Marco Tosi, Claudia Fabiani, Luca Cantarini
OBJECTIVES: To describe the epidemiology of non-infectious uveitis (NIU) in two tertiary referral rheumatology units in Central and Southern Italy. METHODS: Two hundred and seventy-eight consecutive NIU patients (417 eyes) evaluated between January 2016 and January 2017 were enrolled. Collected data were analysed in accordance with the primary anatomic site of inflammation, clinical course, and laterality. RESULTS: The mean age at NIU onset was 36...
November 2018: Clinical and Experimental Rheumatology
Scott A Vincent, Paul A Anderson
Instability of the spine is a complex clinical entity that exists on a wide spectrum encompassing many aspects of spinal pathology including traumatic, neoplastic, infectious, and degenerative processes. The importance of determining stability is paramount in the decision-making process regarding the need for operative or nonoperative care. Defining clinical instability can be a challenging and requires careful attention to the pathology involved, findings of necessary imaging, and a thorough clinical exam...
December 2018: Seminars in Ultrasound, CT, and MR
Humberto Morales
Infectious processes of the spine are on the rise; in this scenario recognition of entities imitating infection is very important. The discovertebral unit is regarded as one of the most important and active sites in the spine. Importantly, the vertebral bony rim and the anterior corners of the vertebral bodies have significant vascularization, they are the last regions to ossify in the developmental process and suffer mechanical forces. Early septic or aseptic discitis-osteomyelitis, properly called spondylitis, involves these anterior regions...
December 2018: Seminars in Ultrasound, CT, and MR
Xuepeng Wang, Shaobo Zhou, Zhenyu Bian, Maoqiang Li, Wu Jiang, Changju Hou, Liulong Zhu
BACKGROUND: The treatment of lumbar infectious spondylitis is controversial. In this study, we attempted to demonstrate that unilateral percutaneous endoscopic debridement with physiologic saline and negative pressure drainage postoperatively may achieve a satisfactory result in lumbar infectious spondylitis. METHODS: We retrospectively analyzed 17 patients with lumbar infectious spondylitis who underwent percutaneous endoscopic debridement and drainage (PEDD) through a posterolateral transforaminal approach...
December 3, 2018: Journal of Orthopaedic Surgery and Research
Desislava Kalinova, Rasho Rashkov
Infectious spondylodiscitis is characterized by vertebral osteomyelitis, spondylitis, and discitis. Patients present with persistent low back pain, fever, or neurological findings. Diagnosis is made with a combination of clinical, radiological, and laboratory findings. Magnetic resonance tomography (MRI) has high sensitivity and specificity in diagnosis and differentiation of the type of spondylodiscitis and may reveal signs of spondylodiscitis even in very early stages. Infectious spondylodiscitis responds to antimicrobial therapy well if diagnosed early before development of neurological deficit and requirement of surgical intervention...
2018: Reumatologia
Durgesh Dubey, Sandeep Kumar, Smriti Chaurasia, Anupam Guleria, Sakir Ahmed, Rajeev Singh, Reena Kumari, Dinesh Raj Modi, Ramnath Misra, Dinesh Kumar
Reactive arthritis (ReA) is a member of seronegative spondyloarthropathy (SSA), which involves an acute/subacute onset of asymmetrical lower limb joint inflammation weeks after a genitourinary/gastrointestinal infection. The diagnosis is clinical because it is difficult to culture the microbes from synovial fluid. Arthritis patients with a similar clinical picture but lapsed history of an immediate preceding infection that do not fulfill the diagnostic criteria of other members of SSA, such as ankylosing spondylitis, psoriatic arthritis, and arthritis associated with inflammatory bowel disease, are labeled as peripheral undifferentiated spondyloarthropathy (uSpA)...
October 30, 2018: Journal of Proteome Research
James E Frampton
SB5 (Imraldi® ) is a biosimilar of the reference anti-TNF monoclonal antibody adalimumab. It is approved for use in the following indications for which reference adalimumab is approved: rheumatoid arthritis (RA), juvenile idiopathic arthritis [polyarticular juvenile idiopathic arthritis (pJIA) and enthesitis-related arthritis (ERA)], axial spondyloarthritis [ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA)], psoriatic arthritis (PsA), psoriasis, pediatric plaque psoriasis, hidradenitis suppurativa (HS), Crohn's disease, pediatric Crohn's disease, ulcerative colitis (UC), and non-infectious uveitis...
October 2018: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
Pavel Skok, Kristjan Skok
Crohn's disease is a chronic inflammatory bowel disease. The disease is characterized by acute exacerbations with diarrhea, abdominal pain, fever, anorexia, intestinal bleeding, and weight loss. Immune-mediated diseases that are frequently associated with Crohn's disease include arthritis, ankylosing spondylitis, sacroiliitis, episcleritis, uveitis, and skin lesions, such as erythema nodosum and pyoderma gangrenosum. The authors present the case of a 22-year-old female patient that was admitted to their hospital due to diarrhea, fever, arthralgias, and diffuse erythematous papules and plaques with vesicles and pustules affecting the patient's face, lips, arms, trunk, and legs...
September 2018: Acta Dermatovenerologica Alpina, Panonica, et Adriatica
Gokhan Keser, Kenan Aksu
There are no universally accepted diagnostic criteria for large-vessel vasculitides (LVV), including giant cell arteritis (GCA) and Takayasu arteritis (TAK). Currently, available classification criteria cannot be used for the diagnosis of GCA and TAK. Early diagnosis of these two diseases is quite challenging in clinical practice and may be accomplished only by combining the patient symptoms, physical examination findings, blood test results, imaging findings, and biopsy results, if available. Awareness of red flags which lead the clinician to investigate TAK in a young patient with persistent systemic inflammation is helpful for the early diagnosis...
September 17, 2018: Rheumatology International
Eamon Maloney, Sachin Srinivasan, Timothy Shaver
Chronic ankylosing spondylitis can lead to several rare long-term complications including cauda equina syndrome and inflammatory discitis especially without treatment. These complications are uncommon, but there is evidence that they can be treated with anti-tumor necrosis factor (TNF) inhibitors. We present a case of a 52-year-old male with a 30-year history of undiagnosed ankylosing spondylitis with cauda equina syndrome on initial outpatient presentation with a negative lumbosacral magnetic resonance imaging (MRI)...
July 12, 2018: Curēus
Peng Wu, Yu-Jiao Zhang, Fang Qin, Lan Liu, Shu-Jun Cui
Objective To explore the value of fractional anisotropy(FA) and apparent diffusion coefficient(ADC) in the early diagnosis of intervertebral disc change in patients with Brucella spondylitis(BS) and in the assessment of BS disc changes after treatment and to further investigate the imaging features of BS in its acute,subacute,and chronic stages. Methods Totally 60 serologically or pathologically confirmed BS patients who were treated in the First Hospital Affiliated to Hebei North University(n=20) or ZhangJiakou Infectious Diseases Hospital(n=40) were enrolled...
August 30, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
M D Becker, R Max, A Dimitriou, T Saurenmann, H-M Lorenz, A Jansen, S Lortz, J Grulich-Henn, M Weber
Intraocular inflammation with the imprecise and broad umbrella term "uveitis" is a diagnostic and therapeutic challenge in ophthalmology. Uveitis is one of the most common causes of blindness worldwide and due to the associated costs is comparable to diabetic retinopathy. Patients can be affected by uveitis at any age. Any part of the eye may be affected. The symptoms range from complete absence of symptoms, through all types of vision deterioration up to a red and even very painful eye. Uveitis can be strictly unilateral (also alternating from the left to the right eye) or bilateral with a relapsing or chronic course...
June 7, 2018: Zeitschrift Für Rheumatologie
María Fernández-Prada, Anahy María Brandy-García, Omar Darío Rodríguez-Fonseca, Ismael Huerta-González, Federico Fernández-Noval, Carmen Martínez-Ortega
OBJECTIVE: Vaccination coverage for seasonal influenza and pneumococcus in rheumatology patients receiving biological treatment. To identify variables that predict vaccination adherence. MATERIAL AND METHOD: Descriptive cross-sectional study. The study involved rheumatology patients who initiated biological therapy between 01/01/2016 and 12/31/2016 in a regional referral hospital. Variables included sociodemographic information, diagnostic data, treating physician, referral to the vaccine unit and vaccination against pneumococcus with 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23), as well as seasonal influenza (2016/17)...
May 8, 2018: Reumatología Clinica
Marta Mora González, Marissé Masís Solano, Travis C Porco, Catherine E Oldenburg, Nisha R Acharya, Shan C Lin, Matilda F Chan
BACKGROUND: The purpose of this study is to assess the relationship between self-reported uveitis and purported demographic and clinical risk factors, using an American adult population extracted from the National Health and Nutrition Examination Survey (NHANES) for the years 2009 and 2010. This is a cross-sectional, population-based study using a sample of 5106 subjects between 20 and 69 years old. The main outcome for our study was the self-report of a diagnosis of uveitis. The demographic analysis included age, gender, and ethnicity...
April 17, 2018: Journal of Ophthalmic Inflammation and Infection
Eun Jee Song, Ji Seon Park, Kyung Nam Ryu, So Young Park, Wook Jin
BACKGROUND: Perineural spread is not an uncommon feature in carcinoma of the head and neck. On the contrary, perineural spread in pelvic malignancies has been rarely reported. This is the first report on perineural spread of the obturator nerve and the lumbosacral plexus from primary vaginal cancer. CASE DESCRIPTION: A 50-year-old woman diagnosed with infectious spondylitis at an outside hospital was referred to our institution. She presented with persistent lower back pain and right anterior thigh pain...
July 2018: World Neurosurgery
A Majjad, A Bezza, A Biyi, M R El Ochi, A El Maghraoui
Antitumor necrosis factor therapies have revolutionized the treatment of some inflammatory diseases. However, the use of these agents is associated with the development of many paradoxical autoimmune diseases. Less well-recognized is the association with sarcoidosis. We report a 55-year-old female with long-standing ankylosing spondylitis who developed persistent dry cough and dyspnea while receiving etanercept therapy. High-resolution computed tomography scanning showed mediastinal lymphadenopathy and multiple nodules in both lung fields developed two months after the administration of etanercept...
2018: Case Reports in Rheumatology
Yangwon Lee, Bum-Joon Kim, Se-Hoon Kim, Seung-Hwan Lee, Won-Hyung Kim, Sung-Won Jin
Objective: Spondylitis is often chemotherapy resistant and requires long-term treatment. Without adequate chemotherapy, the outcome can be fatal or result in severe neurologic damage. Therefore, differentiating the etiology of spondylitis is very important, particularly in spontaneous cases. As the prevalence of tuberculosis in Korea has decreased in recent years, updated clinical research about spondylitis is warranted. Methods: From April 2010 to March 2016, data from spondylitis patients were collected retrospectively...
January 2018: Journal of Korean Neurosurgical Society
Charles G Colip, Mina Lotfi, Karen Buch, Nagaraj Holalkere, Bindu N Setty
PURPOSE: Spinal MRI is the exam of choice for the workup of patients with suspected spinal infection. In this retrospective study, we assess the value of obtaining contrast-enhanced spinal MRI for patients presenting to the emergency department (ED) with acute back pain and a history of intravenous drug use (IVDU). METHODS: A retrospective IRB-approved, HIPAA compliant review of the imaging findings, reports and electronic charts of 167 consecutive IV drug-using patients (M/F = 96:71, mean age = 40 years) that presented to the ED with acute back pain over a 55-month period and underwent contrast-enhanced spinal MRI within 24 h...
June 2018: Emergency Radiology
Shih-Chieh Yang, Hung-Shu Chen, Yu-Hsien Kao, Yuan-Kun Tu
AIM: To evaluate the clinical and radiographic results of patients with complicated infectious spondylitis treated with single-stage anterior debridement and reconstruction using tantalum mesh cage (TaMC) followed by immediate instrumentation. METHODS: Single-stage radical debridement and subsequent reconstruction with TaMC instead of autograft or allograft were performed to treat 20 patients with spinal deformity or instability due to complicated infectious spondylitis...
September 18, 2017: World Journal of Orthopedics
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