1.Clinical and imaging characteristics of bone and joint damage derived from brucellosis
Yuqiu SUN ; Binhe CHEN ; Keqin WU ; Xiaojing ZHANG ; Shuzhen CHANG
Chinese Journal of Endemiology 2017;36(5):378-381
Objective To provide data evidence for early diagnosis of bone and joint damage derived from brucellosis by analyzing its clinical and imaging characteristics.Methods Patients with brucellosis accepted in Ji'nan Infectious Disease Hospital form December 2013 to December 2014 were selected.Patients with bone and joint damage confirmed through imaging were further studied,their epidemiological and clinical characters,CT and MRI characteristics,treatment and outcome were summarized.Results Total of 97.8% (45/46) patients had a clear contact history,most of them worked in poultry farming,taking up to 67.4% (31/46).July to October was its peak time for attacking,taking up to 58.7% (27/46).The clinical manifestations of patients were joint pain,swelling and activities obstacles.In the CT images,there was obvious bony destruction,characterized by multiple round or large areas of low density insect damage sample spots.There was osteosclerotic bone lesions or osteophyte formatted in edge.The paravertebral soft tissue was swelling,and the vertebral body deformation was not obvious,and there was vertebra small joint damage occasionally.In the MRI images,there was vertebral ligaments damage,or soft tissue damage,or osteoproliferation at the edge of the vertebral bodies.There was abnormal signal T1W1 or T2W1 signal,and FS-T1W1 showed high signal,while FS-T2W1 showed slightly high signal.The diagnosis rate of CT,MRI and CT combined MRI for bone and joint damage derived from brucellosis was 76.1% (35/46),84.8% (39/46) and 91.3% (42/46),respectively.The main therapeutic drugs were doxycycline and rifampicin,and the clinical effective rate was 91.3% (42/46).Conclusion The epidemiological characters,CT and MRI characteristics of bone and joint damage derived from brucellosis have certain representativeness,and the comprehensive investigation is beneficial for clinical diagnosis.