151
|
Cui Y, Zhang X, Zhao Z, Liu Y, Zheng J. The relationship between histopathological and imaging features of sacroiliitis. Int J Clin Exp Med 2015; 8:5904-5910. [PMID: 26131183 PMCID: PMC4483981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 03/31/2015] [Indexed: 06/04/2023]
Abstract
This study aimed to investigate the histopathological feature of sacroiliitis and to examine its relationship with imaging features using various imaging techniques. Computed-tomography (CT)-guided needle biopsy of the sacroiliac (SI) joints was performed in 36 patients with spondyloarthritis. Histopathological examination was performed on the samples and subjects were divided as with or without sacroiliitis according histopathology. Magnetic resonance imaging (MRI), Single-photon emission CT (SPECT), CT scans and plain X-rays of the SI joints were conducted. Histopathological changes indicative of sacroiliitis were found in 29 (81%) of the 36 patients, with changes in cartilage (72.4%) and subchondral bone (72.4%) being the most common features. Histopathological sacroiliitis was not found in seven (19.4%) patients. Using MRI, sacroiliitis was found in 29 (80.5%) patients. Increased SI index (> 1.34) by SPECT scans indicative of sacroiliitis was found in 29 (80.5%) patients. Sacroiliitis was detected by CT and plain X-rays in 23 (63.8%) and 19 (52.7%) patients, respectively. Using the histopathological sacroiliitis as the gold standard, sensitivity for SPECT, MRI, CT and plain X-rays was 92.8%, 96.4%, 73.3%, respectively, and 64.2% and the corresponding specificity was 62.5%, 75%, 87.5% and 87.5%, respectively. Needle biopsy is an important method for the diagnosis of sacroiliitis. MRI and SPECT have comparable diagnostic value as CT and plain X-rays and can quantify the inflammatory activity. A combination of these two techniques could increase the sensitivity and specificity and serve as a valuable tool for the diagnosis, assessment and monitoring of sacroiliitis.
Collapse
Affiliation(s)
- Yang Cui
- Department of Rheumatism, Guangdong General HospitalNo. 106 Zhongshaner Road, Guangzhou, China
| | - Xiao Zhang
- Department of Rheumatism, Guangdong General HospitalNo. 106 Zhongshaner Road, Guangzhou, China
| | - Zhenjun Zhao
- Medical Imaging Centre, Guangdong General HospitalGuangzhou, China
| | - Yanhui Liu
- Depatment of Pathology, Guangdong General HospitalGuangzhou, China
| | - Jinping Zheng
- Department of Rheumatism, Guangdong General HospitalNo. 106 Zhongshaner Road, Guangzhou, China
| |
Collapse
|
152
|
Abstract
Novel imaging techniques have emerged in the field of spondyloarthritis. This article will cover the role of, and the sensitivity and specificity of magnetic resonance imaging (MRI) and ultrasound in the diagnosis and monitoring of axial and peripheral SpA. It will discuss how the definition of a 'positive MRI' of the sacroiliac joints and spine is evolving. Differential diagnoses of inflammatory lesions of both the sacroiliac joints and the spine are addressed due to their importance in image interpretation. The article will also discuss the role of sonography in assessing peripheral entheses, joints, tendon sheaths, nails and soft tissues. The utility for clinical as well as an outcome measure will be discussed. We finally aim to give guidance on when and how to use these new modalities and on how to analyse and interpret the imaging findings in daily practice.
Collapse
|
153
|
Lin C, MacKenzie JD, Courtier JL, Gu JT, Milojevic D. Magnetic resonance imaging findings in juvenile spondyloarthropathy and effects of treatment observed on subsequent imaging. Pediatr Rheumatol Online J 2014; 12:25. [PMID: 25067925 PMCID: PMC4110533 DOI: 10.1186/1546-0096-12-25] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 06/29/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is often used to diagnose and monitor treatment effects of juvenile spondyloarthropathy (SpA). Our objective was to describe MRI findings in juvenile SpA and determine predictors of active sacroiliitis and response to treatment. METHODS Children who had MRI of the sacroiliac (SI) joints and were referred to the pediatric rheumatology clinic from 2009 to 2012 were retrospectively studied. The clinical parameters, laboratory studies and findings on MRI were collected and a composite score ratio (CR) was calculated for both SI joints on each MRI study based on a semi-quantitative scale that included evaluation of bone marrow edema (BME), synovial enhancement (SE), and erosions (ER). The findings on MRI were correlated with clinical and laboratory values. RESULTS 50 subjects who underwent 76 MRI for suspected or known SpA were included in the study. Sacroiliitis was seen in 48 MRIs in 32 subjects. Of the subjects with sacroiliitis, mean age ± standard deviation was 13.7 ± 2.6 years, 71% were male and 41% were HLA B27 positive. SE without BME was seen in 31% cases of sacroiliitis. In subjects with sacroiliitis, 79% also had hip arthritis and 41% had enthesitis of the pelvic region on MRI. In 38% of subjects with sacroiliitis, physical exam was not indicative of sacroiliitis or hip arthritis. Longitudinal data were available for 13 subjects. Sacroiliitis on MRI improved in 9 subjects with the greatest improvement in MRI composite score ratio after initiation of etanercept therapy. CR improvement was due to improvement of BME and SE components, while the ER score remained the same or worsened in all but 1 subject. CONCLUSION History, physical exam or laboratory data may not predict sacroiliitis in children. Magnetic resonance imaging plays a valuable role in the initial evaluation and later treatment monitoring of children with spondyloarthropathy. Synovial enhancement is significantly reduced after treatment, and unlike adults, synovial enhancement may be detected without accompanying bone marrow edema, which suggests gadolinium contrast may be an important component in the assessment of children with spondyloarthropathy.
Collapse
Affiliation(s)
- Clara Lin
- Children’s Hospital Colorado Pediatric Rheumatology, 13123 East 16th Street, Box B311, 80045 Aurora, CO, USA
| | - John D MacKenzie
- UCSF Pediatric Radiology, 505 Parnassus Ave, Moffitt Room: M396, Box 0628, 94143 San Francisco, CA, USA
| | - Jesse L Courtier
- UCSF Pediatric Radiology, 505 Parnassus Ave, Moffitt Room: M396, Box 0628, 94143 San Francisco, CA, USA
| | - Jeffrey T Gu
- UCSF Pediatric Radiology, 505 Parnassus Ave, Moffitt Room: M396, Box 0628, 94143 San Francisco, CA, USA
| | - Diana Milojevic
- Floating Hospital for Children @ Tufts Medical Center, 800 Washington Street #190, 02111 Boston, MA, USA
| |
Collapse
|
154
|
Bozgeyik Z, Aglamis S, Bozdag PG, Denk A. Magnetic resonance imaging findings of musculoskeletal brucellosis. Clin Imaging. 2014;38:719-723. [PMID: 24849195 DOI: 10.1016/j.clinimag.2014.04.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 03/18/2014] [Accepted: 04/14/2014] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The aim of this retrospective study was to determine the magnetic resonance imaging (MRI) findings of patients with musculoskeletal brucellosis. MATERIALS AND METHODS Sixty-eight among 304 patients with musculoskeletal brucellosis, aged 12-82 years (average, 50.2 years), were included in the study. Patients were diagnosed based on clinical findings, Brucella agglutination tests, and MRI findings. MRI was performed to all of the patients with sacroiliitis, spondylitis-spondylodiscitis, and peripheral arthritis. RESULTS Brucella serum agglutination test was >1/160 in all cases and blood cultures were positive in twelve cases. The most commonly affected site was the spine (57.3%), wherein lumbar vertebrae were found to be most commonly affected. The second most common affected site was sacroiliac joint (26.4%), whereas peripheral joints were affected in 11 cases (16.1%). CONCLUSION Brucellosis may affect various sites in musculoskeletal system. The spine was the most frequently affected site in our study. Sacroiliac joints and the other peripheral joints were less commonly involved sites. Brucellosis should be included in the differential diagnosis of a patient with arthralgia or symptoms of musculoskeletal system disorders especially in endemic areas.
Collapse
|
155
|
Xiong J, Chen J, Tu J, Ye W, Zhang Z, Liu Q, Zhu X. Association of HLA-B27 status and gender with sacroiliitis in patients with ankylosing spondylitis. Pak J Med Sci 2014; 30:22-7. [PMID: 24639824 PMCID: PMC3955535 DOI: 10.12669/pjms.301.3896] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 11/23/2013] [Accepted: 11/26/2013] [Indexed: 01/18/2023] Open
Abstract
Objective: To observe the influence of human leucocyte antigen B27 (HLA-B27) status and gender on sacroiliitis on computed tomography (CT) in ankylosingspondylitis (AS). Methods: We reviewed the archived medical records of the AS inpatients admitted in the Rheumatology Department of the First Affiliated Hospital of Wenzhou Medical University during the period from January 2007 through January 2013 and finally 386 patients were included in the study. The severity of sacroiliitis on CT was evaluated according to the grading used in the modified New York criteria for AS. Two-way classification analysis of variance (ANOVA) was employed to examine the effect of HLA-B27 status and gender on age at disease onset. The impact of HLA-B27 and gender on sacroiliitis on CT was tested by univariate and multivariate logistic regression analyses. Results: There were 350 HLA-B27 positive patients (90.7%) and 36 HLA-B27 negative patients (9.3%). The ANOVA test indicated that HLA-B27 positive patients and male patients respectively had an earlier age at disease onset than HLA-B27 negative patients and female patients. The logistic regression analysis indicated that positive HLA-B27 status (OR 2.601, p=0.004) and male gender (OR 1.923, p=0.004) were significant predictors of worse sacroiliitis. In addition, elevated ESR (OR 2.181, p=0.013) and longer disease duration (OR 1.100, p<0.001) contributed to worse sacroiliitis likewise. Conclusion: Positive HLA-B27 status and male gender are associated with worse sacroiliitis on CT, acting as predictors of sacroiliitis. Elevated ESR and longer disease duration also contribute to worse sacroiliitis. Meanwhile, positive HLA-B27 status and male gender are associated with earlier age at disease onset.
Collapse
Affiliation(s)
- Jiangbiao Xiong
- Jiangbiao Xiong, Department of Rheumatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, PR China
| | - Jing Chen
- Jing Chen, Department of Rheumatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, PR China
| | - Jianxin Tu
- Jianxin Tu, Department of Rheumatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, PR China
| | - Wenjing Ye
- Wenjing Ye, Department of Rheumatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, PR China
| | - Zhiyong Zhang
- Zhiyong Zhang, Department of Rheumatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, PR China
| | - Qiaoqiong Liu
- Qiaoqiong Liu, Department of Rheumatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, PR China
| | - Xiaochun Zhu
- Xiaochun Zhu, Department of Rheumatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, PR China
| |
Collapse
|
156
|
Garg B, Jalan D, Kotwal PP. Ewing's Sarcoma of the Sacroiliac Joint Presenting as Tubercular Sacroiliitis: A Diagnostic Dilemma. Asian Spine J 2014; 8:79-83. [PMID: 24596610 DOI: 10.4184/asj.2014.8.1.79] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 10/23/2012] [Accepted: 10/23/2012] [Indexed: 11/08/2022] Open
Abstract
We report a case of Ewing's sarcoma of the sacroiliac joint in a 21-year-old male mimicking tubercular sacroiliitis, a rare entity not reported in literature. He presented with pain in the lower back radiating to the right lower limb along with constitutional symptoms of 3 months duration. On examination, the right sacroiliac joint was tender. The laboratory investigations showed anaemia, leukocytosis and raised erythrocyte sedimentation rate. On X-ray, features of right sacroiliitis were seen. This was further investigated with magnetic resonance imaging (MRI), which showed features consistent with tubercular sacroiliitis. Patient was then started on antitubercular treatment, but the improvement was not consistent. So, a contrast MRI was done, which indicated features of primary sarcoma. It was then further confirmed by a computed tomography-guided biopsy, which showed features consistent with Ewing's sarcoma of the sacroiliac joint.
Collapse
|
157
|
Lorio MP, Polly DW, Ninkovic I, Ledonio CGT, Hallas K, Andersson G. Utilization of Minimally Invasive Surgical Approach for Sacroiliac Joint Fusion in Surgeon Population of ISASS and SMISS Membership. Open Orthop J 2014; 8:1-6. [PMID: 24551025 PMCID: PMC3924210 DOI: 10.2174/1874325001408010001] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 12/16/2013] [Accepted: 12/18/2013] [Indexed: 11/22/2022] Open
Abstract
Introduction: The sacroiliac joint (SIJ) may be a source of chronic low back pain in 15 -22% of patients. Over
the past four years MIS is an emerging standard of care for SI joint fusion. The International Society for the Advancement
of Spine Surgery (ISASS) and Society for Minimally Invasive Spine Surgery (SMISS) conducted a survey of their
members to examine current preferences in surgeon practice of MIS SI fusion. Methods: To qualify for survey participation, the surgeon had to perform at least one open or MIS SIJ fusion procedure
between 2009 and 2012. All surgeons were instructed to review their records. This included the number of surgical
procedures performed annually from 2009-2012, site of service where each procedure was commonly performed, and
average length of stay for each approach. Results: Twenty four percent (121/500) of the eligible members participated in this survey. This survey revealed that the
percentage of MIS procedures increased from 39% in 2009 to over 87% in 2012. The survey showed a significant increase
in average number of MIS surgeries and a significant difference between open and MIS surgeries in 2012 (p<0.0001). In
addition, 80% of the survey respondents indicated a lack of preference toward open approach if that was the only
available option. Conclusions: According to performed survey, MIS SIJ fusion is preferred over open technique. Incorporation of the MIS
technique into the spine surgeon's specter of skills would allow an increased number of surgical options as well as
possible increase in outcome quality.
Collapse
Affiliation(s)
| | - David W Polly
- Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Ivana Ninkovic
- Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | | | | | - Gunnar Andersson
- Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
158
|
Cardile S, Romano C. Current issues in pediatric inflammatory bowel disease-associated arthropathies. World J Gastroenterol 2014; 20:45-52. [PMID: 24415857 PMCID: PMC3886031 DOI: 10.3748/wjg.v20.i1.45] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 10/17/2013] [Accepted: 11/05/2013] [Indexed: 02/06/2023] Open
Abstract
Joint involvement is the most common extraintestinal manifestation in children with inflammatory bowel disease (IBD) and may involve 16%-33% of patients at diagnosis or during follow-up. It is possible to distinguish asymmetrical, transitory and migrating arthritis (pauciarticular and polyarticular) and spondyloarthropathy (SpA). Clinical manifestations can be variable, and peripheral arthritis often occurs before gastrointestinal symptoms develop. The inflammatory intestinal pattern is variable, ranging from sub-clinical inflammation conditions, classified as indeterminate colitis and nodular lymphoid hyperplasia of the ileum, to Crohn’s disease or ulcerative colitis. Unlike the axial form, there is an association between gut inflammation and evolution of recurrent peripheral articular disease that coincides with a flare-up of intestinal disease. This finding seems to confirm a key role of intestinal inflammation in the pathogenesis of SpA. An association between genetic background and human leukocyte antigen-B27 status is less common in pediatric than n adult populations. Seronegative sacroiliitis and SpA are the most frequent forms of arthropathy in children with IBD. In pediatric patients, a correct therapeutic approach relies on the use of nonsteroidal antiinflammatory drugs, local steroid injections, physiotherapy and anti-tumor necrosis factor therapy (infliximab). Early diagnosis of these manifestations reduces the risk of progression and complications, and as well as increasing the efficacy of the therapy.
Collapse
|
159
|
Darton Y, Richard I, Truc MC. Osteomyelitis variolosa: A probable mediaeval case combined with unilateral sacroiliitis. Int J Paleopathol 2013; 3:288-293. [PMID: 29539566 DOI: 10.1016/j.ijpp.2013.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 05/28/2013] [Accepted: 05/31/2013] [Indexed: 05/25/2023]
Abstract
Osteoarticular sequelae of smallpox (osteomyelitis variolosa) are uncommon today. Such lesions may be observed occasionally, however, in countries where the disease has been endemic. Without other forms of documentation, it is possible to suggest a diagnosis of smallpox in ancient skeletal remains and thus make a significant contribution to understanding the history of this disease. We have examined a subadult male (Skeleton 833), 15-17 years old at the time of death, who presents bilateral bone manifestations of the elbows suggestive of smallpox. No other bone is similarly affected. In addition, he presents a left sacroiliitis deemed to be a brucellar manifestation. Skeleton 833 is one of at least 730 individuals from an exhaustive excavation of a mediaeval necropolis at Pont-sur-Seine (Aube, north-eastern France). Radiocarbon dating of his bones yields a date of between AD 1022 and 1155 (calibrated), thus apparently the oldest case described to date. The other published cases correspond to more recent periods with a well established historical context. We argue that this example of osteomyelitis variolosa.
Collapse
Affiliation(s)
- Yves Darton
- CEPAM (UMR 7264, CNRS/UNS), Pôle universitaire Saint-Jean d'Angély - SJA3, 24, avenue des Diables Bleus, 06357 Nice cedex 4, France.
| | - Isabelle Richard
- CEPAM (UMR 7264, CNRS/UNS), Pôle universitaire Saint-Jean d'Angély - SJA3, 24, avenue des Diables Bleus, 06357 Nice cedex 4, France; INRAP Grand Est Nord, 12, rue de Méric, 57063 Metz cedex 2, France
| | | |
Collapse
|
160
|
Sanaei Dashti A, Karimi A. Skeletal Involvement of Brucella melitensis in Children: A Systematic Review. Iran J Med Sci 2013; 38:286-92. [PMID: 24293781 PMCID: PMC3838979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 01/19/2013] [Accepted: 02/24/2013] [Indexed: 11/20/2022]
Abstract
Brucellosis is a protean disease and should be excluded in any febrile child with a constellation of symptoms such as fever, malaise, sweating, arthralgia, and joint swelling in endemic areas. Skeletal system involvement is the most common source of complaints in brucellosis. The frequency of skeletal involvement in children is 6.4% to 73.5%. There are some controversies regarding the most common sites of involvement: sacroiliac versus peripheral joints. In the vast majority of cases, peripheral joint involvement in pediatric brucellosis has a monoarticular pattern, although there is no agreement about the most commonly involved peripheral joint. In this systematic review, published articles that describe the bone involvement of Brucella melitensis, as the most prevalent kind of the microorganism in the region, in children are evaluated.
Collapse
Affiliation(s)
- Anahita Sanaei Dashti
- Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdollah Karimi
- Pediatric Infections Research Center, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
161
|
Banegas Illescas ME, López Menéndez C, Rozas Rodríguez ML, Fernández Quintero RM. [New ASAS criteria for the diagnosis of spondyloarthritis: diagnosing sacroiliitis by magnetic resonance imaging]. Radiologia 2013; 56:7-15. [PMID: 24119715 DOI: 10.1016/j.rx.2013.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 04/21/2013] [Accepted: 05/10/2013] [Indexed: 11/19/2022]
Abstract
Radiographic sacroiliitis has been included in the diagnostic criteria for spondyloarthropathies since the Rome criteria were defined in 1961. However, in the last ten years, magnetic resonance imaging (MRI) has proven more sensitive in the evaluation of the sacroiliac joints in patients with suspected spondyloarthritis and symptoms of sacroiliitis; MRI has proven its usefulness not only for diagnosis of this disease, but also for the follow-up of the disease and response to treatment in these patients. In 2009, The Assessment of SpondyloArthritis international Society (ASAS) developed a new set of criteria for classifying and diagnosing patients with spondyloarthritis; one important development with respect to previous classifications is the inclusion of MRI positive for sacroiliitis as a major diagnostic criterion. This article focuses on the radiologic part of the new classification. We describe and illustrate the different alterations that can be seen on MRI in patients with sacroiliitis, pointing out the limitations of the technique and diagnostic pitfalls.
Collapse
Affiliation(s)
- M E Banegas Illescas
- Servicio de Radiodiagnóstico, Hospital General Universitario de Ciudad Real, Ciudad Real, España.
| | - C López Menéndez
- Servicio de Radiodiagnóstico, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - M L Rozas Rodríguez
- Servicio de Radiodiagnóstico, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - R M Fernández Quintero
- Servicio de Radiodiagnóstico, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| |
Collapse
|
162
|
Ozmen O, Gökçek A, Tatcı E, Biner I, Akkalyoncu B. Integration of PET/CT in Current Diagnostic and Response Evaluation Methods in Patients with Tuberculosis. Nucl Med Mol Imaging 2013; 48:75-8. [PMID: 24900142 DOI: 10.1007/s13139-013-0236-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 08/28/2013] [Accepted: 09/02/2013] [Indexed: 10/26/2022] Open
Abstract
Tuberculosis is a systemic disease that still affects many people. While pleural involvement is frequently observed in extrapulmonary tuberculosis, multiple skeletal system and articular involvements are quite rare. FDG PET imaging could be a promising diagnostic and treatment monitoring method, especially in complicated cases and if the other methods are inadequate. In this case study, we report a patient who was admitted with suspected malignancy and then diagnosed with tuberculosis pleuritis, lymphadenitis, spondylodiscitis, and sacroiliitis with specific symptoms; the response to anti-tuberculosis therapy was shown using FDG PET/CT.
Collapse
Affiliation(s)
- Ozlem Ozmen
- Department of Nuclear Medicine, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, 06280 Ankara, Turkey
| | - Atila Gökçek
- Department of Radiology, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Ebru Tatcı
- Department of Nuclear Medicine, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, 06280 Ankara, Turkey
| | - Inci Biner
- Department of Nuclear Medicine, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, 06280 Ankara, Turkey
| | - Behiye Akkalyoncu
- Department of Chest Diseases, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
163
|
Kwan BYM, Osman S, Barra L. Spinal gout in a young patient with involvement of thoracic, lumbar and sacroiliac regions. Joint Bone Spine 2013; 80:667-8. [PMID: 23566660 DOI: 10.1016/j.jbspin.2013.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 02/22/2013] [Indexed: 11/19/2022]
|
164
|
Hwangbo Y, Kim HJ, Park JS, Ryu KN, Kim NH, Shim J, Jang JY, Dong SH, Kim BH, Chang YW, Chang R. Sacroiliitis is common in Crohn's disease patients with perianal or upper gastrointestinal involvement. Gut Liver 2010; 4:338-44. [PMID: 20981210 DOI: 10.5009/gnl.2010.4.3.338] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Accepted: 02/02/2010] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND/AIMS Sacroiliitis (SI) is one of the most frequent extraintestinal manifestations in inflammatory bowel disease (IBD) patients, but the exact prevalence has not been evaluated in Asia. There are few data on the association between SI and other clinical features of IBD. The prevalence of SI was evaluated using computed tomography (CT) and the phenotypic parameters associated with SI in Korean IBD patients were determined. METHODS Eighty-two patients with ulcerative colitis (UC) and 81 patients with Crohn's disease (CD) were evaluated clinically. The presence of SI was evaluated using bone window setting of abdomino-pelvic CT images by two radiologists. RESULTS The prevalence rates of SI were 12.2% and 21.0% in the UC and CD groups, respectively. There was no relationship between the localization or extent of intestinal inflammation and the presence of SI in the UC group. Multivariate analyses confirmed that perianal and upper-gastrointestinal (from the mouth through to the jejunum) diseases were associated with the occurrence of SI in the CD group (p=0.026 and p=0.047, respectively). CONCLUSIONS SI was as common among Korean IBD patients as among Western patients. Perianal or upper-gastrointestinal involvement is associated with SI in CD patients.
Collapse
Affiliation(s)
- Young Hwangbo
- Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
165
|
Colombo E, Latiano A, Palmieri O, Bossa F, Andriulli A, Annese V. Enteropathic spondyloarthropathy: A common genetic background with inflammatory bowel disease? World J Gastroenterol 2009; 15:2456-62. [PMID: 19468994 PMCID: PMC2686902 DOI: 10.3748/wjg.15.2456] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The association between spondyloarthropathy and inflammatory bowel disease (IBD) is largely established, although prevalence is variable because of different population selection and diagnostic methodologies. Most studies indicate that as many as 10%-15% of cases of IBD are complicated by ankylosing spondylitis (AS) or other forms of spondylarthritis (SpA). Of note, ileal inflammation resembling IBD has been reported in up to two thirds of cases of SpA, and it has been suggested that the presence of ileitis is associated with the chronicity of articular complications. Although this observation is of interest to unravel the pathophysiology of the disease, systematic screening of patients with SpA by ileocolonoscopy is not indicated in the absence of gut symptoms, as only a small proportion of patients with subclinical gut inflammation will develop overt IBD over time. The existence of familial clustering of both IBD and AS, the coexistence of both conditions in a patient, the evidence of an increased risk ratio among first- and second-degree relatives of affected AS or IBD patients and finally, the increased cross-risk ratios between AS and IBD, strongly suggest a shared genetic background. So far, however, IL23R is the only identified susceptibility gene shared by both IBD and AS. Although functional studies are still needed to better understand its pathogenic role, great effort is being spent therapeutically targeting this pathway that may prove effective for both disorders.
Collapse
|