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Epidemiologic, Clinical, and Imaging Findings in Brucellosis Patients with Osteoarticular Involvement

Aysin Pourbagher1, Mir Ali Pourbagher1, Lutfu Savas2, Tuba Turunc3, Yusuf Ziya Demiroglu3, Ilknur Erol4 and Defne Yalcintas5

1 Department of Radiology, Baskent University Adana Teaching and Medical Research Center, Dadaloglu Mah., 39 Sok No 6, Yuregir, 01250 Adana, Turkey.
2 Department of Infectious Diseases, Mustafa Kemal University Faculty of Medicine, Antakya, Turkey.
3 Department of Infectious Diseases, Baskent University Adana Teaching and Medical Research Center, Adana, Turkey.
4 Department of Pediatrics, Baskent University Adana Teaching and Medical Research Center, Adana, Turkey.
5 Department of Biostatistics, Baskent University Adana Teaching and Medical Research Center, Adana, Turkey.


Figure 1
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  		Fig. 1 —46-year-old man with brucellosis. Posterior planar image from radionuclide bone scintigraphy shows increased uptake in region of right sacroiliac joint.

 

Figure 2
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  		Fig. 2A —MRI of 55-year-old woman with brucellosis and spondylodiskitis in contiguous thoracic and lumbar vertebrae. Sagittal spin-echo T1-weighted image shows decreased signal intensity in bodies of T11-L2 vertebrae.

 

Figure 3
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  		Fig. 2B —MRI of 55-year-old woman with brucellosis and spondylodiskitis in contiguous thoracic and lumbar vertebrae. Turbo spin-echo T2-weighted image shows increased signal intensity in bodies of affected vertebrae (arrows) and abnormal signal extending across disk space.

 

Figure 4
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  		Fig. 3A —MRI of 55-year-old man with brucellosis and noncontiguous multifocal thoracic spondylodiskitis. Sagittal spin-echo T1-weighted image shows decreased signal intensity in T6-T7 and T9-T10 vertebral bodies (arrows).

 

Figure 5
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  		Fig. 3B —MRI of 55-year-old man with brucellosis and noncontiguous multifocal thoracic spondylodiskitis. Sagittal turbo spin-echo T2-weighted image shows increased signal intensity in affected vertebrae with irregular vertebral body endplates and narrowing of intervertebral disk spaces (arrowheads).

 

Figure 6
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  		Fig. 3C —MRI of 55-year-old man with brucellosis and noncontiguous multifocal thoracic spondylodiskitis. Sagittal gadolinium-enhanced T1-weighted image shows areas of enhancement in affected vertebral bodies (open arrows) and disks (solid arrows).

 

Figure 7
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  		Fig. 4A —MRI of 63-year-old man with brucellosis and cervical spondylodiskitis. Sagittal spin-echo T1-weighted images show decreased signal of contiguous involvement of C5-C7 vertebra (A) and heterogeneously increased signal (B) after IV injection of gadolinium in affected vertebrae with irregular vertebral body endplates.

 

Figure 8
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  		Fig. 4B —MRI of 63-year-old man with brucellosis and cervical spondylodiskitis. Sagittal spin-echo T1-weighted images show decreased signal of contiguous involvement of C5-C7 vertebra (A) and heterogeneously increased signal (B) after IV injection of gadolinium in affected vertebrae with irregular vertebral body endplates.

 

Figure 9
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  		Fig. 5 —34-year-old man with brucellosis. Transverse T1-weighted spin-echo MR image obtained after IV injection of gadolinium shows heterogeneous enlargement of soft tissue to right of patient's spine (arrows). Abscess is area of low signal intensity in mid portion of inflamed muscle (arrowheads).

 

Figure 10
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  		Fig. 6A —MRI of 66-year-old man with brucellosis and T7-T8 spondylodiskitis. Sagittal spin-echo T1-weighted image (A), sagittal turbo spin-echo T2-weighted image (B), and sagittal spin-echo T1-weighted image after IV injection of gadolinium (C) show T8 vertebral collapse and cord and root compression. These are also features of tuberculous spondylodiskitis (Pott's disease).

 

Figure 11
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  		Fig. 6B —MRI of 66-year-old man with brucellosis and T7-T8 spondylodiskitis. Sagittal spin-echo T1-weighted image (A), sagittal turbo spin-echo T2-weighted image (B), and sagittal spin-echo T1-weighted image after IV injection of gadolinium (C) show T8 vertebral collapse and cord and root compression. These are also features of tuberculous spondylodiskitis (Pott's disease).

 

Figure 12
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  		Fig. 6C —MRI of 66-year-old man with brucellosis and T7-T8 spondylodiskitis. Sagittal spin-echo T1-weighted image (A), sagittal turbo spin-echo T2-weighted image (B), and sagittal spin-echo T1-weighted image after IV injection of gadolinium (C) show T8 vertebral collapse and cord and root compression. These are also features of tuberculous spondylodiskitis (Pott's disease).

 

Figure 13
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  		Fig. 7A —MRI of 6-year-old boy with brucellosis and osteomyelitis of tibia. Coronal spin-echo T1-weighted (A) and turbo spin-echo T2-weighted (B) images show involvement of metaphysis and epiphysis (arrows).

 

Figure 14
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  		Fig. 7B —MRI of 6-year-old boy with brucellosis and osteomyelitis of tibia. Coronal spin-echo T1-weighted (A) and turbo spin-echo T2-weighted (B) images show involvement of metaphysis and epiphysis (arrows).

 

Figure 15
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  		Fig. 8A —MRI of 20-year-old woman with brucellosis and osteomyelitis of right iliac bone. Transverse spin-echo T1-weighted image shows region of low signal intensity (arrowheads) in wing of right iliac bone.

 

Figure 16
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  		Fig. 8B —MRI of 20-year-old woman with brucellosis and osteomyelitis of right iliac bone. Turbo spin-echo T2-weighted image shows high signal intensity (arrowheads) at same site.

 

Figure 17
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  		Fig. 9A —MRI of 49-year-old woman with brucellosis and osteomyelitis and abscess formation at left sternoclavicular junction. Coronal spin-echo T1-weighted image shows low signal intensity at junction and in soft tissue (arrows).

 

Figure 18
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  		Fig. 9B —MRI of 49-year-old woman with brucellosis and osteomyelitis and abscess formation at left sternoclavicular junction. Transverse turbo spin-echo T2-weighted image shows high signal intensity in these same zones and evidence of abscess formation (arrow).

 

Figure 19
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  		Fig. 10 —Frog-leg radiograph of 9-year-old boy with brucellosis shows extensive subchondral fracture and collapse of right femoral head.

 

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