Osteoarticular Manifestations of Brucellosis

Abstract

Osteoarticular manifestations of human brucellosis occur in 20-40% of patients while spondylodiscitis is the most severe form of the bone and joint structures involvements. The aim of this paper is tho show clinical and radiological caracteristics of osteoarticular forms of brucellosis, with special reference to spondylodiscitis. The medical histories of 120 hospitalized patients at the Clinic for Infectious Diseases, Clinical Center of Sarajevo University, diagnosed with brucellosis, were analyzed. Osteoarticular manifestations had sixty-nine patients, representing 78.4% of all localized forms of the disease. Spondylodiscitis represents 40.6% of all osteoarticular manifestations of the disease. Nine patients (32.1%) had paravertebral and paraspinal abscess. Median diagnostic interval for spondylodiscitis (116 +/- 160 days) was almost twice prolonged compared to the arthritis and sacroilitis (p < 0.05). The most common radiological manifestations were erosions of the vertebral surface (67.8%). Computerized tomography confirmed inflammation in 85.2% of the patients, while magnetic resonance imaging (MRI) showed radiological alterations in all patients (100%). Osteoarticular manifestations are the most common localised forms of brucellosis. The frequency of spondylodiscitis is in relation to duration of the diagnostic time. MRI shows a high degree of sensitivity to inflammatory changes of spine and "Pedro Pons' sign" is patognomic radiological alteration.