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CT-guided corticosteroid injection for solitary eosinophilic granuloma of the spine

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Abstract

Objective

To evaluate the clinical and imaging outcome of patients with symptomatic eosinophilic granuloma of the spine treated with CT-guided intralesional methylprednisolone injection after biopsy.

Materials and methods

Patients (n =19) with symptomatic solitary eosinophilic granuloma of the spine treated by CT-guided intralesional methylprednisolone injection were retrospectively studied. There were 12 males and seven females with a mean age of 17 years (range, 3–43 years). The mean follow-up was 6 years (median, 4 years; range, 0.5–19 years). Spinal location included the cervical (two patients), thoracic (seven patients), lumbar spine (eight patients), and the sacrum (two patients). Vertebra plana was observed in two patients. All patients had biopsies before treatment.

Results

Complete resolution of pain and healing of the lesion was observed in 17 patients (89.5%); none of these patients had recurrence at the latest examination. Reconstitution of the T1 and L1 vertebra plana was observed in both patients. Two patients initially diagnosed and treated for a solitary eosinophilic granuloma had constant pain after the procedure; in these patients, 6 and 12 months after the procedure, respectively, imaging showed multifocal disease and systemic therapy was administered. Complications related to the procedure were not observed. General anesthesia was administered in two patients because of intolerable pain during the procedure.

Conclusions

In view of the benign clinical course of eosinophilic granuloma, in patients with symptomatic lesions, CT-guided intralesional corticosteroid injection is a safe and effective outpatient treatment with a low complication rate.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Radiology and Interventional Angiographic Radiology, Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy

    Eugenio Rimondi & Giuseppe Rossi

  2. Department of Orthopedics, Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy

    Andreas F. Mavrogenis, Giuseppe Ussia, Andrea Angelini & Pietro Ruggieri

  3. Department of Orthopaedics, Orthopaedic Oncology Service, Istituto Ortopedico Rizzoli, University of Bologna, Via Di Barbiano 1/10, 40136, Bologna, Italy

    Andreas F. Mavrogenis

  4. Department of Orthopaedics, Istituto Ortopedico Rizzoli, University of Bologna, Via Di Barbiano 1/10, 40136, Bologna, Italy

    Pietro Ruggieri

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  1. Eugenio Rimondi
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  2. Andreas F. Mavrogenis
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  3. Giuseppe Rossi
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  6. Pietro Ruggieri
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Correspondence to Pietro Ruggieri.

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Rimondi, E., Mavrogenis, A.F., Rossi, G. et al. CT-guided corticosteroid injection for solitary eosinophilic granuloma of the spine. Skeletal Radiol 40, 757–764 (2011). https://doi.org/10.1007/s00256-010-1045-7

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  • DOI: https://doi.org/10.1007/s00256-010-1045-7

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