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Wangaryattawanich P, Condos AM, Rath TJ. Bacterial and Viral Infectious Disease of the Spine. Magn Reson Imaging Clin N Am 2024; 32:313-333. [PMID: 38555143 DOI: 10.1016/j.mric.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Spinal infections are a diverse group of diseases affecting different compartments of the spine with variable clinical and imaging presentations. Diagnosis of spinal infections is based on a combination of clinical features, laboratory markers, and imaging studies. Imaging plays a pivotal role in the diagnosis and management of spinal infections. The characteristic imaging manifestations of bacterial and viral infections in the spine are discussed with key teaching points emphasized.
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Affiliation(s)
- Pattana Wangaryattawanich
- Department of Radiology, University of Washington School of Medicine, 1959 Northeast Pacific Street, Seattle, WA 98195-7115, USA.
| | - Amy M Condos
- Department of Radiology, University of Washington School of Medicine, 2545 Northeast 85th Street Seattle, WA 98115, USA
| | - Tanya J Rath
- Neuroradiology Section, Department of Radiology, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA
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Crombé A, Fadli D, Clinca R, Reverchon G, Cevolani L, Girolami M, Hauger O, Matcuk GR, Spinnato P. Imaging of Spondylodiscitis: A Comprehensive Updated Review-Multimodality Imaging Findings, Differential Diagnosis, and Specific Microorganisms Detection. Microorganisms 2024; 12:893. [PMID: 38792723 PMCID: PMC11123694 DOI: 10.3390/microorganisms12050893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/11/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024] Open
Abstract
Spondylodiscitis is defined by infectious conditions involving the vertebral column. The incidence of the disease has constantly increased over the last decades. Imaging plays a key role in each phase of the disease. Indeed, radiological tools are fundamental in (i) the initial diagnostic recognition of spondylodiscitis, (ii) the differentiation against inflammatory, degenerative, or calcific etiologies, (iii) the disease staging, as well as (iv) to provide clues to orient towards the microorganisms involved. This latter aim can be achieved with a mini-invasive procedure (e.g., CT-guided biopsy) or can be non-invasively supposed by the analysis of the CT, positron emission tomography (PET) CT, or MRI features displayed. Hence, this comprehensive review aims to summarize all the multimodality imaging features of spondylodiscitis. This, with the goal of serving as a reference for Physicians (infectious disease specialists, spine surgeons, radiologists) involved in the care of these patients. Nonetheless, this review article may offer starting points for future research articles.
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Affiliation(s)
- Amandine Crombé
- Department of Musculoskeletal Imaging, Pellegrin University Hospital, Bordeaux University, Place Amélie Raba-Léon, F-33000 Bordeaux, France
| | - David Fadli
- Department of Musculoskeletal Imaging, Pellegrin University Hospital, Bordeaux University, Place Amélie Raba-Léon, F-33000 Bordeaux, France
| | - Roberta Clinca
- Department of Radiology, IRCCS Policlinico di Sant’Orsola, 40138 Bologna, Italy
| | - Giorgio Reverchon
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Luca Cevolani
- Orthopedic Oncology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Marco Girolami
- Department of Spine Surgery Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Olivier Hauger
- Department of Musculoskeletal Imaging, Pellegrin University Hospital, Bordeaux University, Place Amélie Raba-Léon, F-33000 Bordeaux, France
| | - George R. Matcuk
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Paolo Spinnato
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
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Telli T, Desaulniers M, Pyka T, Caobelli F, Forstmann S, Umutlu L, Fendler WP, Rominger A, Herrmann K, Seifert R. What Role Does PET/MRI Play in Musculoskeletal Disorders? Semin Nucl Med 2023:S0001-2998(23)00091-0. [PMID: 38044175 DOI: 10.1053/j.semnuclmed.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 11/13/2023] [Indexed: 12/05/2023]
Abstract
Musculoskeletal disorders of nononcological origin are one of the most frequent reasons for consultation. Patients suffering from musculoskeletal disorders also consult more than once for the same reason. This results in multiple clinical follow-ups after several radiological and serum examinations, the main ones including X-rays targeting the painful anatomical region and inflammatory serum parameters. As part of their work up, patients suffering from musculoskeletal disorders often require multisequence, multi-parameter MRI. PET/MRI is a promising imaging modality for their diagnosis, with the added advantage of being able to be performed in a single visit. PET/MRI is particularly useful for diagnosing osteomyelitis, spondylodiscitis, arthritis, many pediatric pathologies, and a wide range of other musculoskeletal pathologies. PET/MRI is already used to diagnose malignant bone tumors such as osteosarcoma. However, current knowledge of the indications for PET/MRI in nononcological musculoskeletal disorders is based on studies involving only a few patients. This review focuses on the usefulness of PET/MRI for diagnosing nononcological musculoskeletal disorders.
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Affiliation(s)
- Tugce Telli
- Department of Nuclear Medicine, West German Cancer Center, University Hospital Essen, Essen, Germany.
| | - Mélanie Desaulniers
- Department of Nuclear Medicine, West German Cancer Center, University Hospital Essen, Essen, Germany; Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Thomas Pyka
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Federico Caobelli
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Sophia Forstmann
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, Essen, Germany
| | - Lale Umutlu
- Department of Radiology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Wolfgang P Fendler
- Department of Nuclear Medicine, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Ken Herrmann
- Department of Nuclear Medicine, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Robert Seifert
- Department of Nuclear Medicine, West German Cancer Center, University Hospital Essen, Essen, Germany; Department of Nuclear Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
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Lacroix M, Nguyen C, Burns R, Laporte A, Rannou F, Feydy A. Degenerative Lumbar Spine Disease: Imaging and Biomechanics. Semin Musculoskelet Radiol 2022; 26:424-438. [PMID: 36103885 DOI: 10.1055/s-0042-1748912] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Chronic low back pain (CLBP) is one of the most common diagnoses encountered when considering years lived with disability. The degenerative changes of the lumbar spine include a wide spectrum of morphological modifications visible on imaging, some of them often asymptomatic or not consistent with symptoms. Phenotyping by considering both clinical and imaging biomarkers can improve the management of CLBP. Depending on the clinical presentation, imaging helps determine the most likely anatomical nociceptive source, thereby enhancing the therapeutic approach by targeting a specific lesion. Three pathologic conditions with an approach based on our experience can be described: (1) pure painful syndromes related to single nociceptive sources (e.g., disk pain, active disk pain, and facet joint osteoarthritis pain), (2) multifactorial painful syndromes, representing a combination of several nociceptive sources (such as lumbar spinal stenosis pain, foraminal stenosis pain, and instability pain), and (3) nonspecific CLBP, often explained by postural (muscular) syndromes.
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Affiliation(s)
- Maxime Lacroix
- Department of Musculoskeletal Radiology, Hôpital Cochin, Université de Paris, Paris, France.,Department of Radiology, Hôpital Européen Georges-Pompidou, Université de Paris, Paris, France
| | - Christelle Nguyen
- Department of Physical and Rehabilitation Medicine, Hôpital Cochin, Université de Paris, Paris, France
| | - Robert Burns
- Department of Musculoskeletal Radiology, Hôpital Cochin, Université de Paris, Paris, France
| | - Amandine Laporte
- Department of Musculoskeletal Radiology, Hôpital Cochin, Université de Paris, Paris, France
| | - François Rannou
- Department of Physical and Rehabilitation Medicine, Hôpital Cochin, Université de Paris, Paris, France
| | - Antoine Feydy
- Department of Musculoskeletal Radiology, Hôpital Cochin, Université de Paris, Paris, France
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Weber MA, Bazzocchi A, Nöbauer-Huhmann IM. Tumors of the Spine: When Can Biopsy Be Avoided? Semin Musculoskelet Radiol 2022; 26:453-468. [PMID: 36103887 DOI: 10.1055/s-0042-1753506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Regarding osseous tumors of the spine, characteristic morphology is encountered in hemangioma of the vertebral body, osteoid osteoma (OO), osteochondroma, Paget's disease, and bone islands. In these cases, radiologic imaging can make a specific diagnosis and thereby avoid biopsy, especially when the radiologist has chosen the correct imaging modality to establish the diagnosis, such as thin-slice computed tomography in suspected OO. A benign lesion is suggested by a high amount of fat within the lesion, the lack of uptake of the contrast agent, and a homogeneous aspect without solid parts in a cystic tumor. Suspicion of malignancy should be raised in spinal lesions with a heterogeneous disordered matrix, distinct signal decrease in T1-weighted magnetic resonance imaging, blurred border, perilesional edema, cortex erosion, and a large soft tissue component. Biopsy is mandatory in presumed malignancy, such as any Lodwick grade II or III osteolytic lesion in the vertebral column. The radiologist plays a crucial role in determining the clinical pathway by choosing the imaging approach wisely, by narrowing the differential diagnosis list, and, when characteristic morphology is encountered, by avoiding unnecessary biopsies.
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Affiliation(s)
- Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, The Rizzoli Orthopedic Institute, Bologna, Italy
| | - Iris-M Nöbauer-Huhmann
- Department of Biomedical Imaging and Image Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
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