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Abstract：
UNASSIGNED: Brucellosis is a common global zoonotic disease with a wide range of complex and nonspecific clinical manifestations that may lead to misdiagnosis and delayed treatment. Osteoarticular involvement is the most common complaint in brucellosis.
UNASSIGNED: This present study aims to describe the clinical and laboratory characteristics and treatment of brucellosis patients with arthritis and sacroiliitis.
UNASSIGNED: This retrospective descriptive study was performed on patients presenting to a teaching hospital in Kermanshah, Iran with a diagnosis of brucellosis from 2011 to 2019. The demographic and clinical characteristics, complications, laboratory findings, and treatment were recorded during the study period. Then, the difference in the collected data was investigated between brucellosis patients with and without arthritis or sacroiliitis.
UNASSIGNED: Of 425 patients studied, 130 (30.58%) had osteoarticular involvement. Among them, 41 (9.64%) and 58 (13.6%) patients were diagnosed with arthritis and sacroiliitis, respectively. There were no significant demographic differences between patients with and without brucellar arthritis or sacroiliitis (p > 0.05). The patients with Brucella arthritis had a significantly higher frequency of arthralgia and radiculopathy (p ⩽ 0.05). Sacroiliitis was significantly more common in patients with arthralgia, neck pain, and low back pain, positive flexion-abduction-external rotation (FABER) test, radiculopathy, and vertebral tenderness compared to patients without sacroiliitis (p ⩽ 0.05), while fever and headache were significantly more common in patients without sacroiliitis (p ⩽ 0.05). The median Wright and 2-Mercapto Ethanol titers were higher in brucellosis patients with arthritis or sacroiliitis versus patients without arthritis or sacroiliitis, but the difference was not significant (p > 0.05). Synovial fluid had been analyzed in 20 cases. The mean white blood cell count, glucose, and protein level were 3461 ± 2.70 cells/mm3, 58.54 ± 31.43 mg/dL, and 8.6 ± 11.85 g/dL, respectively. In 80% of the subjects, neutrophil cells were predominant. There were no significant laboratory differences between patients with and without brucellar arthritis or sacroiliitis, except for a higher median platelet count in patients with arthritis and higher median levels of aspartate aminotransferase (AST) and alkaline phosphatase (ALP) in patients with sacroiliitis. Most cases of arthritis and sacroiliitis were diagnosed with ultrasound (31.8%) and FABER test (79.3%), respectively.
UNASSIGNED: Arthritis and sacroiliitis were the two most important and common manifestations of brucellar osteoarthritis with a frequency of 9.64% and 13.6%, respectively. Any complaints of low back pain and radiculopathy as well as the presence of spondylitis in patients should raise suspicion of sacroiliitis. High levels of AST and ALP and a high platelet count may be associated with brucellar sacroiliitis and arthritis, respectively. The use of imaging methods such as MRI and bone scan seems necessary for the diagnosis of sacroiliitis.
UNASSIGNED: This present study aims to describe the clinical and laboratory characteristics and treatment of brucellosis patients with arthritis and sacroiliitis.
UNASSIGNED: This retrospective descriptive study was performed on patients presenting to a teaching hospital in Kermanshah, Iran with a diagnosis of brucellosis from 2011 to 2019. The demographic and clinical characteristics, complications, laboratory findings, and treatment were recorded during the study period. Then, the difference in the collected data was investigated between brucellosis patients with and without arthritis or sacroiliitis.
UNASSIGNED: Of 425 patients studied, 130 (30.58%) had osteoarticular involvement. Among them, 41 (9.64%) and 58 (13.6%) patients were diagnosed with arthritis and sacroiliitis, respectively. There were no significant demographic differences between patients with and without brucellar arthritis or sacroiliitis (p > 0.05). The patients with Brucella arthritis had a significantly higher frequency of arthralgia and radiculopathy (p ⩽ 0.05). Sacroiliitis was significantly more common in patients with arthralgia, neck pain, and low back pain, positive flexion-abduction-external rotation (FABER) test, radiculopathy, and vertebral tenderness compared to patients without sacroiliitis (p ⩽ 0.05), while fever and headache were significantly more common in patients without sacroiliitis (p ⩽ 0.05). The median Wright and 2-Mercapto Ethanol titers were higher in brucellosis patients with arthritis or sacroiliitis versus patients without arthritis or sacroiliitis, but the difference was not significant (p > 0.05). Synovial fluid had been analyzed in 20 cases. The mean white blood cell count, glucose, and protein level were 3461 ± 2.70 cells/mm3, 58.54 ± 31.43 mg/dL, and 8.6 ± 11.85 g/dL, respectively. In 80% of the subjects, neutrophil cells were predominant. There were no significant laboratory differences between patients with and without brucellar arthritis or sacroiliitis, except for a higher median platelet count in patients with arthritis and higher median levels of aspartate aminotransferase (AST) and alkaline phosphatase (ALP) in patients with sacroiliitis. Most cases of arthritis and sacroiliitis were diagnosed with ultrasound (31.8%) and FABER test (79.3%), respectively.
UNASSIGNED: Arthritis and sacroiliitis were the two most important and common manifestations of brucellar osteoarthritis with a frequency of 9.64% and 13.6%, respectively. Any complaints of low back pain and radiculopathy as well as the presence of spondylitis in patients should raise suspicion of sacroiliitis. High levels of AST and ALP and a high platelet count may be associated with brucellar sacroiliitis and arthritis, respectively. The use of imaging methods such as MRI and bone scan seems necessary for the diagnosis of sacroiliitis.
摘要：
■布鲁氏菌病是一种常见的全球性人畜共患疾病，具有广泛的复杂和非特异性临床表现，可能导致误诊和延误治疗。骨关节受累是布鲁氏菌病最常见的主诉。
■本研究旨在描述患有关节炎和骶髂关节炎的布鲁氏菌病患者的临床和实验室特征及治疗。
■这项回顾性描述性研究是针对在克尔曼沙的教学医院就诊的患者进行的，伊朗2011年至2019年诊断为布氏杆菌病。人口统计学和临床特征，并发症,实验室发现,和治疗记录在研究期间。然后，调查了有和没有关节炎或骶髂关节炎的布鲁氏菌病患者之间收集到的数据的差异.
■在研究的425名患者中，130例(30.58%)有骨关节受累。其中,41例（9.64%）和58例（13.6%）患者被诊断为关节炎和骶髂关节炎，分别。有和没有布脑关节炎或骶髂关节炎的患者之间没有显著的人口统计学差异(p>0.05)。布鲁氏菌关节炎患者的关节痛和神经根病的发生频率明显较高（p﹤0.05）。骶髂关节炎在关节痛患者中更为常见，颈部疼痛,和腰痛，屈曲-外展-外旋(FABER)试验阳性,神经根病,与没有骶髂关节炎的患者相比，椎体压痛(p﹤0.05)，而发烧和头痛在没有骶髂关节炎的患者中明显更常见(p﹤0.05)。与没有关节炎或骶髂关节炎的患者相比，患有关节炎或骶髂关节炎的布鲁氏菌病患者的中位Wright和2-Mercapto乙醇滴度较高。但差异不显著(p>0.05)。对20例滑液进行了分析。平均白细胞计数,葡萄糖，蛋白水平分别为3461±2.70细胞/mm3,58.54±31.43mg/dL,和8.6±11.85g/dL，分别。在80%的科目中，中性粒细胞占优势。有和没有布脑关节炎或骶髂关节炎的患者之间没有显著的实验室差异，除了关节炎患者的血小板计数中位数较高,骶髂关节炎患者的谷草转氨酶(AST)和碱性磷酸酶(ALP)中位数较高.大多数关节炎和骶髂关节炎病例经超声(31.8%)和FABER试验(79.3%)诊断,分别。
■关节炎和骶髂关节炎是布氏杆菌骨性关节炎的两种最重要和最常见的表现，发生率分别为9.64%和13.6%，分别。任何对腰痛和神经根病的抱怨以及患者是否存在脊柱炎的抱怨都应引起对骶髂关节炎的怀疑。高水平的AST和ALP以及高的血小板计数可能与布鲁氏菌骶髂关节炎和关节炎有关。分别。使用MRI和骨扫描等成像方法对于骶髂关节炎的诊断似乎是必要的。
■本研究旨在描述患有关节炎和骶髂关节炎的布鲁氏菌病患者的临床和实验室特征及治疗。
■这项回顾性描述性研究是针对在克尔曼沙的教学医院就诊的患者进行的，伊朗2011年至2019年诊断为布氏杆菌病。人口统计学和临床特征，并发症,实验室发现,和治疗记录在研究期间。然后，调查了有和没有关节炎或骶髂关节炎的布鲁氏菌病患者之间收集到的数据的差异.
■在研究的425名患者中，130例(30.58%)有骨关节受累。其中,41例（9.64%）和58例（13.6%）患者被诊断为关节炎和骶髂关节炎，分别。有和没有布脑关节炎或骶髂关节炎的患者之间没有显著的人口统计学差异(p>0.05)。布鲁氏菌关节炎患者的关节痛和神经根病的发生频率明显较高（p﹤0.05）。骶髂关节炎在关节痛患者中更为常见，颈部疼痛,和腰痛，屈曲-外展-外旋(FABER)试验阳性,神经根病,与没有骶髂关节炎的患者相比，椎体压痛(p﹤0.05)，而发烧和头痛在没有骶髂关节炎的患者中明显更常见(p﹤0.05)。与没有关节炎或骶髂关节炎的患者相比，患有关节炎或骶髂关节炎的布鲁氏菌病患者的中位Wright和2-Mercapto乙醇滴度较高。但差异不显著(p>0.05)。对20例滑液进行了分析。平均白细胞计数,葡萄糖，蛋白水平分别为3461±2.70细胞/mm3,58.54±31.43mg/dL,和8.6±11.85g/dL，分别。在80%的科目中，中性粒细胞占优势。有和没有布脑关节炎或骶髂关节炎的患者之间没有显著的实验室差异，除了关节炎患者的血小板计数中位数较高,骶髂关节炎患者的谷草转氨酶(AST)和碱性磷酸酶(ALP)中位数较高.大多数关节炎和骶髂关节炎病例经超声(31.8%)和FABER试验(79.3%)诊断,分别。
■关节炎和骶髂关节炎是布氏杆菌骨性关节炎的两种最重要和最常见的表现，发生率分别为9.64%和13.6%，分别。任何对腰痛和神经根病的抱怨以及患者是否存在脊柱炎的抱怨都应引起对骶髂关节炎的怀疑。高水平的AST和ALP以及高的血小板计数可能与布鲁氏菌骶髂关节炎和关节炎有关。分别。使用MRI和骨扫描等成像方法对于骶髂关节炎的诊断似乎是必要的。
