1/38. Pyogenic arthritis of a lumbar facet joint.We herein report the case of a 68-year-old man with diabetes who developed pyogenic arthritis of a lumbar facet joint after spinal injection. We performed magnetic resonance imaging (MRI), computed tomography (CT), technetium 99 methylene diphosphonate scintigraphy, and single photon emission computed tomography (SPECT) for this patient. MRI showed a lesion in the facet joint and no evidence of spondylodiscitis. CT showed a swelling of periarticular soft tissue around the facet joint. Bone scintigraphy showed a characteristic vertical uptake. In particular, SPECT was able to clearly confirm the location of the infection. An infection of the facet joint has only been rarely reported, but we recommended that this area should be carefully evaluated whenever a patient develops an infection of the lumbar spine after a spinal injection.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
2/38. STIR sequence in infectious sacroiliitis in three patients.magnetic resonance imaging (MRI) provides the most detailed evaluation of the sacroiliac (SI) joint and surrounding soft tissue. Therefore, this technique represents the most sensitive and specific method in early diagnosis of infectious sacroiliitis. Among three patients diagnosed as having infectious sacroiliitis in our hospital, the short tau inversion recovery sequence (STIR) was found to be more effective than the T1 contrast-enhanced sequence, particularly in delineating all findings of the SI joint inflammation and allowing for the early detection of septic sacroiliitis.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
3/38. Prosthetic joint infections with osteomyelitis due to candida albicans.We report the case of a 78-year-old woman who suffered from a severe soft tissue and bone infection of her left knee 3 years after a total knee-joint replacement without loosening of her endoprosthesis. Cultures from joint aspiration and tissue specimen identified staphylococcus aureus and candida albicans. Direct microscopic examination of vital spongy bone and fibrous tissue revealed microabscesses and seeds of yeasts inside the fatty marrow and interface. After removal of the prosthesis several soft tissue and bone specimens were taken during planned re-operations. The histological examination showed no morphological changing, no reduction or extinction of the yeast cells under fluconazole therapy with a dosage of 6 mg kg(-1) body weight (400 mg daily). Curing of the fungal infection with eradication of the yeasts in the bony specimens was achieved with higher doses of 12 mg kg(-1) body weight (800 mg day(-1)) over a 2 month regimen in combination with repeated surgical debridements.- - - - - - - - - - ranking = 2keywords = soft (Clic here for more details about this article) |
4/38. Acute pasteurella multocida in total knee arthroplasty.Pasturella multocida is a rare cause of joint sepsis in total joint arthroplasty, and all case reports have identified a distant source of infection from an animal bite that has caused potential hematogenous seeding of the prosthesis. We report a case in which no potential distal wound source was found and the only likely etiology was local wound seeding from an old injury. In that injury, a saddle stirrup had caused a severe traumatic soft tissue injury as a horse had rolled over the patient. We draw attention to the fact that this particular bacteria is virulent in producing septic contamination of a total joint prosthesis, and aggressive treatment is indicated when such infection is identified.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
5/38. Necrotizing fasciitis of the leg presenting with chest wall emphysema.We present the case of a 70-year-old woman with necrotizing fasciitis of the right leg, sepsis and bacteraemia with escherichia coli. Chest wall emphysema, detected on standard radiograph and the presence of air in the soft-tissue of the foot was the reason for prompt surgical drainage in addition to standard fluid resuscitation and antibiotic therapy. There was no evidence of underlying diabetes mellitus, but unknown chronic renal failure and corticosteroid therapy for rheumatoid arthritis were considered predisposing factors. We present a short overview of this rare life-threatening condition with emphasis on radiological diagnostic modalities.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
6/38. Coccidioidal pneumonia, arthritis, and soft-tissue infection after kidney transplantation.A 60-year-old male kidney transplant recipient presented with pneumonia 4 months after transplantation. coccidioidomycosis was suspected and empirically treated with fluconazole. He was maintained on suppressive fluconazole without problems. Three weeks after discontinuing secondary prophylaxis, the patient experienced coccidioidal arthritis and an infection of the soft tissue of the hand that required debridement. Transplant recipients may have quiescent disseminated coccidioidomycosis that is reactivated by immunosuppression after withdrawal of suppressive antifungal therapy.- - - - - - - - - - ranking = 5keywords = soft (Clic here for more details about this article) |
7/38. Unusual musculoskeletal manifestations of lyme disease.We report on the imaging features of musculoskeletal abnormalities in a 52-year-old woman suffering from lyme disease presenting with acrodermatitis chronica atrophicans (ACA). The patient developed recurrent attacks of migratory asymmetrical oligoarthritis, involving articular and peri-articular structures, including the metatarsophalageal (MTP) joints, scapular bone, thoracic spine, elbow, gluteal area, knee, ankle and metacarpophalangeal (MCP) joints. Six months after the first symptoms, magnetic resonance imaging (MRI) showed bone marrow oedema within the proximal phalanx of the right fifth toe, adjacent to an ACA rash. A year after the onset of the disease, swelling at the right scapular region occurred, and MRI showed osseous, periosteal and soft tissue involvement of the superior margin of the right scapula and adjacent rib. On MRI of the spine, there was bone marrow infiltration with irregular delineation of the anterior corner of the thoracic vertebrae 4 to 6, corresponding to an osteoblastic bony lesion on radiographic examination. This case report is unique, because MRI documentation of bony abnormalities and periarticular soft tissue swelling, accompanying an attack of ACA has never been reported previously. Moreover, involvement of the osseous spine and the scapular bone have never been described in the radiological literature.- - - - - - - - - - ranking = 2keywords = soft (Clic here for more details about this article) |
8/38. Septic arthritis due to aeromonas hydrophila: case report and review of the literature.aeromonas hydrophila is a rare human pathogen, and worldwide, soft tissue infections following water-related injuries are the most common. However, septic arthritis due to A. hydrophila remains uncommon with only seven cases previously reported in the English literature. In this report, we describe the important clinical features, microbiological findings and management of severe septic arthritis of the knee due to A. hydrophila in a healthy 13-year-old girl following an injury sustained in a private fresh water lake. A review of seven previously reported cases of septic arthritis due to A. hydrophila and the present case suggests that the infection commonly affected the knee and the meta-/intercarpal-phalangeal joint and was frequently rapidly progressive following trauma in fresh water and or associated with leukaemia. Second and third generation cephalosporins, gentamicin, trimethoprim, ciprofloxacin and appropriate orthopaedic management should be promptly instituted. After chemical treatment and chlorination, fresh water becomes free of coliforms, but A. hydrophila persists more compared with the other strains of aeromonas, namely A. sobria and A. caviae. seawater injuries, unlike freshwater injuries, are not usually associated with aeromonas infections. Further workup on the mechanisms of A. hydrophila resistance to chlorination could probably yield useful information in achieving new procedures of preventing and controlling such infections in public and private fresh water recreational facilities.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
9/38. Iliofemoral distraction and hip reconstruction for the sequelae of a septic dislocated hip with chronic femoral osteomyelitis.We describe a technique of 'cross-hip distraction' to reduce a dislocated hip with subsequent reconstruction of the joint for septic arthritis with extensive femoral osteomyelitis. A 27-year-old woman presented with a dislocated, collapsed femoral head and chronic osteomyelitis of the femur. Examination revealed a leg-length discrepancy of 7 cm and an irritable hip. A staged technique was used with primary clearance of osteomyelitis and secondary reconstruction of the hip. A cross-hip monolateral external fixator was used to establish normal anatomy followed by an arthroplasty. A good functional outcome was achieved. The use of cross-hip distraction avoids soft-tissue and nerve damage and achieved improved abductor function before arthroplasty.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
10/38. Burkholderia fungorum septicemia.We report the first case of community-acquired bacteremia with Burkholderia fungorum, a newly described member of the burkholderia cepacia complex. A 9-year-old girl sought treatment with septic arthritis in her right knee and ankle with soft tissue involvement. Commercial identification systems did not identify the causative microorganism.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
| | Next -> |