RESUMO
STUDY DESIGN: Case report. OBJECTIVE: Vertebral osteomyelitis, usually presented with back pain and local tenderness, can pose a great challenge of early diagnosis among spinal cord injury (SCI) patients who lost sensation below the injured level. We reported a paraplegic patient who had recurrent febrile episodes after being treated as urinary tract infection initially and was discovered later to have vertebral osteomyelitis. CASE REPORT: A 41-year-old man, completely paralyzed at the T11 level and with Foley catheterization for 9 years, was re-admitted within 2 weeks for recurrent fever, turbid urine, bacteriuria and bacteremia with Escherichia coli. Spine X-ray and renal, cardiac and abdominal ultrasonography showed no definite lesions related to infection in a previous admission. Intermittently febrile episodes continued despite treatment with antibiotics for 1 week. He had no pressure sores or other wounds. Computerized tomography and magnetic resonance imaging showed lumbosacral osteomyelitis and bilateral paravertebral abscess. The patient underwent debridement of paravertebral tissue. Fever subsided soon after surgery and the patient continued antibiotics and remained free of fever at a 1-year follow-up. CONCLUSION: It can be challenging to diagnose vertebral osteomyelitis below injury levels in SCI patients. Vertebral osteomyelitis should be considered in febrile SCI patients even with known infectious foci, as classic symptoms of osteomyelitis are lacking in this population.
Assuntos
Diagnóstico Tardio , Osteomielite/diagnóstico , Osteomielite/etiologia , Paraplegia/complicações , Adulto , Diagnóstico Tardio/efeitos adversos , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/patologia , Humanos , Vértebras Lombares/fisiopatologia , Masculino , Osteomielite/microbiologia , Paraplegia/diagnóstico , Paraplegia/microbiologia , Sacro/fisiopatologia , Infecções Urinárias/complicações , Infecções Urinárias/diagnóstico , Infecções Urinárias/microbiologiaRESUMO
In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned ankle/foot structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.
Assuntos
Tornozelo/diagnóstico por imagem , Pé/diagnóstico por imagem , Doenças Musculoesqueléticas/diagnóstico por imagem , Medicina Física e Reabilitação/métodos , Guias de Prática Clínica como Assunto , Tornozelo/anatomia & histologia , Europa (Continente) , Pé/anatomia & histologia , Humanos , Doenças Musculoesqueléticas/reabilitação , Posicionamento do Paciente , UltrassonografiaRESUMO
In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned knee structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.
Assuntos
Joelho/diagnóstico por imagem , Doenças Musculoesqueléticas/diagnóstico por imagem , Medicina Física e Reabilitação/métodos , Guias de Prática Clínica como Assunto , Europa (Continente) , Humanos , Joelho/anatomia & histologia , Doenças Musculoesqueléticas/reabilitação , Posicionamento do Paciente , UltrassonografiaRESUMO
In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned hip structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.
Assuntos
Quadril/diagnóstico por imagem , Doenças Musculoesqueléticas/diagnóstico por imagem , Medicina Física e Reabilitação/métodos , Guias de Prática Clínica como Assunto , Europa (Continente) , Quadril/anatomia & histologia , Humanos , Doenças Musculoesqueléticas/reabilitação , Posicionamento do Paciente , UltrassonografiaRESUMO
In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned shoulder structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.
Assuntos
Doenças Musculoesqueléticas/diagnóstico por imagem , Medicina Física e Reabilitação/métodos , Guias de Prática Clínica como Assunto , Ombro/diagnóstico por imagem , Sociedades Médicas , Europa (Continente) , Humanos , Doenças Musculoesqueléticas/reabilitação , UltrassonografiaRESUMO
In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned elbow structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.
Assuntos
Cotovelo/diagnóstico por imagem , Medicina Física e Reabilitação/métodos , Guias de Prática Clínica como Assunto , Europa (Continente) , Humanos , Doenças Musculoesqueléticas/diagnóstico por imagem , Doenças Musculoesqueléticas/reabilitação , UltrassonografiaRESUMO
In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned wrist/hand structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.