MRI findings of treated bacterial septic arthritis
MRI findings of treated bacterial septic arthritis
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DOI：
10.1007/s00256-012-1397-2
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发表时间：
2012-12-01
影响因子：
2.1
通讯作者：
Bredella, Miriam A.
中科院分区：
文献类型：
--
作者：
Bierry, Guillaume;Huang, Ambrose J.;Bredella, Miriam A.
本研究的目的是报告在成功治疗细菌性脓毒性关节炎时可能遇到的MRI表现，该研究包括12名患者（8名男性和4名女性;平均年龄38岁，范围9-85），其中13例已证实为细菌性脓毒性关节炎。受累关节包括髋关节（n = 3）、膝关节（n = 3）、肩关节（n = 2）、骶髂关节（n = 2）、踝关节（n = 1）、腕关节（n = 1）和肘关节（n = 1）。比较手术清创后、开始抗生素治疗时和成功治疗后的MRI检查，以观察积液、滑膜、骨和关节周围软组织的变化。影像学表现与微生物和临床表现相关，基线时所有关节均存在关节积液，随访MRI时关节积液显著消退（p = 0.001）。5例病例（38%）存在脓肿，随访时其尺寸显著减小（p = 0.001）。在基线和随访MRI时，在所有关节中均观察到滑膜增强和增厚。基线时10例（77%）和随访MRI时8例（62%）存在肌炎/蜂窝织炎。基线时10个关节（77%）存在骨髓水肿，8个关节（62%）持续存在。在所有病例中，在8个关节（62%）中发现骨侵蚀，并且在随访MRI中持续存在。关节积液和积液的大小似乎是最有可能用于监测脓毒性关节炎治疗的因素，因为在成功治疗后两者均显著降低。滑膜增厚和增强、关节周围肌炎/蜂窝织炎和骨髓水肿即使在感染消退后也可持续存在。
The purpose of this study was to report the MRI findings that can be encountered in successfully treated bacterial septic arthritis.The study included 12 patients (8 male and 4 female; mean age 38 years, range 9-85) with 13 proven cases of bacterial septic arthritis. The joints involved were hip (n = 3), knee (n = 3), shoulder (n = 2), sacroiliac (n = 2), ankle (n = 1), wrist (n = 1), and elbow (n = 1). MRI examinations following surgical debridement and at initiation of antibiotic therapy and after successful treatment were compared for changes in effusion, synovium, bone, and periarticular soft tissues. Imaging findings were correlated with microbiological and clinical findings.Joint effusions were present in all joints at baseline and regressed significantly at follow-up MRI (p = 0.001). Abscesses were present in 5 cases (38 %), and their sizes decreased significantly at follow-up (p = 0.001). Synovial enhancement and thickening were observed in all joints at both baseline and follow-up MRI. Myositis/cellulitis was present in 10 cases (77 %) at baseline and in 8 cases (62 %) at follow-up MRI. Bone marrow edema was present in 10 joints (77 %) at baseline and persisted in 8 joints (62 %). Bone erosions were found in 8 joints (62 %) and persisted at follow-up MRI in all cases.The sizes of joint effusions and abscesses appear to be the factors with the most potential for monitoring therapy for septic arthritis, since both decreased significantly following successful treatment. Synovial thickening and enhancement, periarticular myositis/cellulitis, and bone marrow edema can persist even after resolution of the infection.