Yang Baohui, Hu Hongbo, Chen Jie, He Xijing, Li Haopeng
Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
Biomed Res Int. 2016;2016:8903635. doi: 10.1155/2016/8903635. Epub 2016 Sep 8.
. To evaluate the clinical, laboratory, and radiological presentation of 16 cases of brucellar spondylitis. . The clinical manifestations, laboratory tests, and imaging findings of 16 patients (aged from 24 to 66 years) with brucellar spondylitis treated between September 2012 and September 2014 at the Second Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China) were retrospectively analyzed. . Clinical manifestations included high fever, severe pain, sweating, and fatigue. One patient had epididymitis, and two showed clear signs of spinal nerve damage. Laboratory tests showed elevated erythrocyte sedimentation rate (ESR) and C-reactive protein content. Serum brucella agglutination tests were positive, and 11 brucella blood cultures were positive. Imaging manifestations mainly consisted of abnormal signals in the intervertebral space or abnormal signals in the adjacent vertebral bodies (16/16, 100%) in magnetic resonance imaging (MRI), disc space narrowing (14/16, 88%) in X-ray and MRI, or bone destruction and sclerosis around the damaged zone (13/16, 81%) in computed tomography, with rare cases of psoas abscess (2/16, 13%) and sequestrum (1/16, 6%). . Since brucellar spondylitis exhibited characteristic clinical and imaging manifestations, it could be diagnosed with specific laboratory tests. Early MRI examination of suspected cases could improve rapid diagnosis.
评估16例布鲁氏菌性脊柱炎的临床、实验室及影像学表现。回顾性分析2012年9月至2014年9月在西安交通大学第二附属医院(中国西安)接受治疗的16例布鲁氏菌性脊柱炎患者(年龄24至66岁)的临床表现、实验室检查及影像学检查结果。临床表现包括高热、剧痛、出汗及乏力。1例患者患有附睾炎,2例有明确的脊神经损伤体征。实验室检查显示红细胞沉降率(ESR)及C反应蛋白含量升高。血清布鲁氏菌凝集试验呈阳性,11例布鲁氏菌血培养呈阳性。影像学表现主要包括磁共振成像(MRI)中椎间隙异常信号或相邻椎体异常信号(16/16,100%)、X线及MRI中椎间盘间隙变窄(14/16,88%)或计算机断层扫描中受损区域周围骨质破坏及硬化(13/16,81%),罕见腰大肌脓肿(2/16,13%)及死骨形成(1/16,6%)。由于布鲁氏菌性脊柱炎表现出特征性的临床及影像学表现,可通过特定实验室检查进行诊断。对疑似病例早期进行MRI检查可提高快速诊断率。