Background The clinical and radiological diagnosis of osteoarticular brucellosis is not always easy owever essential for early and effective treatment.
Objectives The aim of this study is to study radiological findings of osteoarticular brucellosis which were reported and confirmed in a rheumatological department.
Methods This is a retrospective study which included medical records of patients treated for osteoarticular brucellosis during the ten past years [2002-2012]. Radiological data were recorded and analysed.
Results Twelve cases of osteoarticular brucellosis were treated during the ten past years. All patients had spondylodiscitis. One patient had elbow bursitis associated. We had no case of peripheral arthritis or sacroiliitis. The mean age was 55 years (range 33 to 79 years) with a male to female ratio about 1. The predisposing conditions were present in 2 cases: diabetes mellitus and cirrhosis. Consumption of raw milk products was noted in 8 cases. The median duration from the onset of symptoms to the diagnosis was 3.6 months (range 1.5 to 6 months). The following symptoms were observed: inflammatory back pain (12 cases), sciatalgia with neurological signs (4 cases), weight loss (11 cases), fever (9 cases) and night sweating (n=7). One patient had symptom of spinal cord compression. C Reactive protein level was increased in 8 cases. Lymphopenia was noted in 4 cases. Wright serology was positive in all cases. Spondylodiscitis was uni-staged in all cases: the lumbar spine was the most commonly involved (8 cases). Standard X-ray showed narrowing of the intervertebral space (10 cases), endplate destruction (8 cases), bone condensation (1 case) and were normal in one case. MRI performed in all cases, had showed low signal intensity on T1-weighted images and high signal intensity on T2 weighted images of the vertebral bodies, endplates and intervertebral disc in all cases. Indeed the following findings were observed: paravertebral abcess formation (3 cases), epidural extension (8 cases), posterior longitudinal ligament elevation (1 case) and psoas abcess (2 cases).
Conclusions MRIduring osteoarticular brucellosis and especially spondylodiscitis provides early diagnosis and well demonstration of paravertebral soft tissue spreading more than standard X-ray.
Disclosure of Interest : None declared
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