Aims and objectives
Differentiation of tuberculous and pyogenic spondylitis is important,
because timely and correctly chosen the type of treatment can reduce the rate of disability and functional impairment.
The purpose of our study was to highlight the radiological differences between tuberculous (TS) and pyogenic spondylitis (PS),
considering some clinical features and cultural distinctions Mycobacterium tuberculosis (M.
tuberculosis) compared with other pyogenic bacteria.
Methods and materials
Retrospectively reviewed medical histories,
CT,
MRI of 20 adult patients with spondylitis: 13 with pyogenic (7 women,
6 men aged 34-67 years),
7 with tuberculous (6 men,
1 woman,
aged 46-66 years).
Diagnoses were based on bacteriological and cultural research and were made clinically,
because of positive antibiotic therapy dynamics.
Pyogenic spondylitis is caused by Staphylococcus aureus and Pseudomonas pyocyanea (in 50% was associated with diabetes),
tuberculosis spondylitis - Mycobacterium tuberculosis.
CT was performed on a 16-slice scanner,
MR - on 0.2 T and 1.0T...
Results
The results of study were summarized in Table 1.
M.
tuberculosis has morphological and cultural differences compared with other pyogenic bacteria.
In our opinion,
these cultural features largely explain the differences in clinical and radiological manifestations of each type of spondylitis.
M.
tuberculosis divides extremely slow and does not produce exotoxins - so we do not have acute inflammatory clinical manifestations and in huge part of cases with TS is more late detection,
with large bone deficits (Fig.
1),
under frequently kyphotic deformities (Fig.
11)....
Conclusion
Conclusions: tuberculous and pyogenic spondylitis have radiological differences,
which can be observed on CT,
MRI,
considering some clinical features.
This may influence the choice of treatment.
In our opinion, cultural features of M.
tuberculosis and pyogenic bacteria largely explain the differences in clinical and radiological manifestations of each type of spondylitis.
It is important that radiologist contacts with the patient,
assesses his clinical condition and correlates with radiological findings obtained.MRI has been useful in the detection of early changes of bone marrow edema and intervertebral...
Personal information
Deresh Nataliya Volodymyrivna
Division of Radiology,
Medical Group «Omega- Kyiv»,
Kyiv,
Ukraine
[email protected]
Sharmazanova Olena Petrivna,
M.D.,
Ph.D.
Head of the Department of Radiology,
Kharkiv Medical Academy of Postgraduate Education,
Kharkiv,Ukraine
[email protected]
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