Abstract：
Fungal musculoskeletal infections often have subacute or indolent manifestations, making it difficult to distinguish them from other diseases and infections, given that they are relatively uncommon. Fungal infections occur by hematogenous spread, direct inoculation, or contiguous extension and may be related to different risk factors, including immunosuppression and occupational activity. The infection can manifest in isolation in the musculoskeletal system or as part of a systemic process. The fungi may be endemic to certain regions or may be found throughout the world, and this can help to narrow the diagnosis of the etiologic agent. Infections such as candidiasis, cryptococcosis, aspergillosis, and mucormycosis are often related to immunosuppression. On the other hand, histoplasmosis, paracoccidioidomycosis, coccidioidomycosis, and blastomycosis can occur in healthy patients in geographic areas where these infections are endemic. Furthermore, infections can be classified on the basis of the site of infection in the body. Some subcutaneous infections that can have osteoarticular involvement include mycetoma, sporotrichosis, and phaeohyphomycosis. Different fungi affect specific bones and joints with greater prevalence. Imaging has a critical role in the evaluation of these diseases. Imaging findings include nonspecific features such as osteomyelitis and arthritis, with bone destruction, osseous erosion, mixed lytic and sclerotic lesions, and joint space narrowing. Multifocal osteomyelitis and chronic arthritis with joint effusion and synovial thickening may also occur. Although imaging findings are often nonspecific, some fungal infections may show findings that aid in narrowing the differential diagnosis, especially when they are associated with the patient\'s clinical condition and history, the site of osteoarticular involvement, and the geographic location. ©RSNA, 2024.
摘要：
真菌肌肉骨骼感染通常有亚急性或惰性表现。很难将它们与其他疾病和感染区分开来，鉴于它们相对不常见。真菌感染是由血行传播引起的，直接接种,或连续延伸，可能与不同的风险因素有关，包括免疫抑制和职业活动。感染可以孤立地表现在肌肉骨骼系统中或作为全身过程的一部分。真菌可能是某些地区特有的，或者可能在世界各地发现，这有助于缩小病原体的诊断范围。感染如念珠菌病，隐球菌病,曲霉病,毛霉菌病通常与免疫抑制有关。另一方面,组织胞浆菌病,副角菌病,球孢子菌病,和芽生菌病可以发生在这些感染流行的地理区域的健康患者中。此外，感染可以根据体内感染部位进行分类。一些皮下感染可累及骨关节，包括肌瘤，孢子丝菌病,和phaeophyphysporcosis。不同真菌以更高的患病率影响特定的骨骼和关节。影像学在这些疾病的评估中起着至关重要的作用。影像学表现包括非特异性特征，如骨髓炎和关节炎，骨骼破坏，骨侵蚀，溶解性和硬化性混合病变，和关节空间缩小。也可能发生多灶性骨髓炎和慢性关节炎，关节积液和滑膜增厚。尽管影像学检查结果通常是非特异性的，一些真菌感染可能显示有助于缩小鉴别诊断范围的发现，特别是当它们与患者的临床状况和病史相关时，骨关节受累的部位，和地理位置。©RSNA,2024.
