Department of Radiology, Division of Musculoskeletal Radiology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, 525 East 68th Street, New York, NY, 10065, USA.
Department of Radiology, Division of Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, 525 East 68th Street, New York, NY, 10065, USA.
Skeletal Radiol. 2024 Oct;53(10):2067-2079. doi: 10.1007/s00256-023-04558-3. Epub 2024 Jan 16.
This article comprehensively reviews current imaging concepts in spinal infection with primary focus on infectious spondylodiscitis (IS) as well as the less common entity of facet joint septic arthritis (FSA). This review encompasses the multimodality imaging appearances (radiographs, CT, MRI, and nuclear imaging) of spinal infection-both at initial presentation and during treatment-to aid the radiologist in guiding diagnosis and successful management. We discuss the pathophysiology of spinal infection in various patient populations (including the non-instrumented and postoperative spine) as well as the role of imaging-guided biopsy. We also highlight several non-infectious entities that can mimic IS (both clinically and radiologically) that should be considered during image interpretation to avoid misdiagnosis. These potential mimics include the following: Modic type 1 degenerative changes, acute Schmorl's node, neuropathic spondyloarthropathy, radiation osteitis, and inflammatory spondyloarthropathy (SAPHO syndrome).
本文全面综述了脊柱感染的影像学概念，重点介绍了感染性脊柱骨髓炎（IS）和不太常见的小关节突化脓性关节炎（FSA）。本综述涵盖了脊柱感染的多种影像学表现（X 线、CT、MRI 和核医学成像），包括初次就诊时和治疗过程中的影像学表现，以帮助放射科医生进行诊断和成功治疗。我们讨论了不同患者人群（包括非器械和术后脊柱）的脊柱感染的病理生理学，以及影像学引导下活检的作用。我们还强调了几种可模仿 IS 的非感染性病变（从临床和影像学角度），在进行图像解读时应考虑这些病变，以避免误诊。这些潜在的类似病变包括以下内容：Modic 型 1 退行性改变、急性 Schmorl 结节、神经源性脊柱关节病、放射性骨炎和炎症性脊柱关节病（SAPHO 综合征）。
