背景技术小关节的化脓性关节炎(SAFJ)被认为是一种罕见类型的脊柱感染。然而,由于人口老龄化,受损主机的增加,以及近年来MRI使用的增加,报告的数量一直在增加。我们报告了罕见的宫颈小关节化脓性关节炎(SACFJ)病例的临床进展,并考虑了一些影像学因素,我们将我们的发现与SACFJ的现有报告进行了比较。案例报告一名73岁的日本妇女出现发烧,麻痹症状,上肢感觉异常.这里,我们报告了一例SACFJ,MRI检查结果允许早期诊断,通过抗生素保守治疗获得了良好的疗程。尽管在治疗开始后93天进行的MRI显示小关节轻微的残余信号变化,到出院后第6个月,症状没有复发.结论如果患者出现神经系统症状,如发热瘫痪和炎症反应增加,医生必须考虑化脓性脊柱炎的可能性,包括SACFJ,并订购MRI。在SACFJ中,硬膜外脓肿几乎是不可避免的,和手术治疗,包括脓肿引流,如果脊髓或麻痹症状进展,则需要。对于SACFJ患者,以及化脓性脊柱炎,MRI可能对确定治疗功效没有帮助。
BACKGROUND Septic arthritis of the facet joint (SAFJ) has been considered a rare type of spinal infection. However, because of the aging of the population, the increase in compromised hosts, and the increase in MRI use in recent years, the number of
reports has been increasing. We report the clinical progress of a rare
case of septic arthritis of the cervical facet joint (SACFJ) with some imaging considerations, and we compare our findings with existing
reports of SACFJ.
CASE REPORT A 73-year-old Japanese woman presented with fever, paralytic symptoms, and paresthesia of the upper limbs. Here, we report a
case of SACFJ in which MRI findings allowed early diagnosis, and a favorable course was obtained by conservative treatment with antibiotics. Although MRI performed 93 days after the initiation of treatment showed a slight residual signal change in the facet joints, no symptoms had recurred by the sixth month after hospital discharge. CONCLUSIONS If a patient develops neurological symptoms such as paralysis with fever and increased inflammatory response, the physician must consider the possibility of pyogenic spondylitis, including SACFJ, and order an MRI. Epidural abscess is almost inevitable in SACFJ, and surgical treatment, including abscess drainage, is required if spinal cord or paralytic symptoms progress. For patients with SACFJ, as well as pyogenic spondylitis, MRI may not be useful in determining treatment efficacy.