Buoncristiani A M, McCullen G, Shin A Y, Bathgate B, Akbarnia B A
Department of Orthopaedic Surgery, Naval Medical Center, San Diego, California, USA.
Spine (Phila Pa 1976). 1998 Apr 1;23(7):839-41. doi: 10.1097/00007632-199804010-00022.
A case report of osteomyelitis of the spinous process.
To describe the diagnosis and successful treatment of a patient with spinous process osteomyelitis.
Spinous process osteomyelitis is exceedingly rare and may be misdiagnosed as paraspinal muscle strain, discitis, or vertebral body osteomyelitis. The clinical presentation of spinous process osteomyelitis is subtle, laboratory findings are nonspecific, and radiographs are often normal.
The diagnosis, treatment, and outcome of two patients with spinous process osteomyelitis (an adult and a child) with insidious, nonspecific lumbar pain and fever are reviewed.
Magnetic resonance imaging with and without gadolinium enhancement demonstrated increased signal of the spinous process with paraspinous musculature enhancement, a finding consistent with spinous process osteomyelitis. Biopsy results demonstrated the presence of staphylococcus aureus in the child and no organisms in the adult. Treatment with intravenous antibiotics led to resolution in both cases.
The use of magnetic resonance imaging technology permitted the early and accurate diagnosis of spinous process osteomyelitis.
棘突骨髓炎的病例报告。
描述一例棘突骨髓炎患者的诊断及成功治疗过程。
棘突骨髓炎极为罕见，可能被误诊为椎旁肌劳损、椎间盘炎或椎体骨髓炎。棘突骨髓炎的临床表现不明显，实验室检查结果无特异性，X线片常正常。
回顾了两名棘突骨髓炎患者（一名成人和一名儿童）的诊断、治疗及结果，这两名患者均有隐匿性、非特异性腰痛和发热症状。
钆增强和未增强的磁共振成像显示棘突信号增强，椎旁肌肉组织强化，这一表现符合棘突骨髓炎。活检结果显示儿童患者存在金黄色葡萄球菌，成人患者未发现病原体。两例患者经静脉抗生素治疗后均痊愈。
磁共振成像技术的应用使得棘突骨髓炎能够得到早期准确诊断。
