Septic arthritis of a lumbar facet joint caused by Staphylococcus aureus.

STUDY DESIGN: Case report of a 35-year-old woman with septic arthritis of a lumbar facet joint. OBJECTIVES: To report a rare case of severe low back pain and the specific differential diagnostic problems. SUMMARY OF BACKGROUND DATA: Differential diagnosis between spondylodiscitis and facet joint septic arthritis on a clinical basis is very difficult. The lesions of the joint appear on a plain film only approximately 1.5 months after onset of the symptoms. Although the radionuclide bone scan is sensitive and shows a more laterally and vertically localized uptake than in spondylodiscitis, this technique is not very specific. Computed tomography scan and magnetic resonance imaging are the most reliable investigations even at the very early stages of the disease. Confirmation of the diagnosis has to be obtained by blood cultures or, in exceptional cases, by direct puncture of the joint. Appropriate antibiotic treatment is in most cases sufficient to heal this lesion. METHODS: The etiology, clinical presentation, technical examinations, and treatment are reviewed. RESULTS: Computed tomography scan and magnetic resonance imaging complemented by positive blood cultures led to the very early diagnosis of septic arthritis of the lumbar facet joint in this relatively young patient. CONCLUSIONS: With our case report we confirm the very small number of data reported in the literature, indicating that infections of the facet joint can be detected at a very early stage using magnetic resonance imaging and computed tomography scan.

Serial maternal plasma concentrations of progesterone and estradiol during the morning, the afternoon and at night throughout normal pregnancy in the cynomolgus macaque.

Total progesterone (P4) and estradiol (E2) were determined in plasma from 10 pregnant cynomolgus macaques, Macaca fascicularis. A non-invasive blood collection technique utilizing a squeeze-cage and a catheter fixed momentarily in the brachial or saphenous vein allowed a 10-min serial blood sampling (SBS) for 3 h in the morning, the afternoon or at night at 30, 50, 70, 90, 110, 130, 150 and 165 days of pregnancy and on the day after delivery, without modifying gestation length or damaging fetal health. During an SBS session, extensive fluctuations of high P4 levels (greater than 10 ng/ml) were sometimes observed and infrequent pulses might occur, while E2 levels fluctuated only slightly but increased progressively. It is concluded that, even with the SBS method, individual differences in hormone patterns still occur throughout pregnancy. We suggest that a single daily P4 or E2 determination is not an accurate indicator of pregnancy normality.

Effect of the sex-linked dwarf gene on circulating levels of 17 beta-estradiol, progesterone and luteinising hormone in the laying hen.

1. The sex-linked dwarf gene did not appear to affect the LH, progesterone (P4) and oestradiol 17-beta (E2) levels around the onset of lay in a sample of White Leghorn hens. 2. A longer interval between oviposition and subsequent ovulation was suggested in dwarf layers by a slower decrease in the P4 plasma concentration after the preovulatory peak and is consistent with the increased oviposition interval already described. 3. A higher ratio of E2/P4 basal levels was found in dwarf layers; this is consistent with their lower number of fast-growing follicles and with their reduced laying rate. 4. Lipid mobilisation was modified in dwarf layers (as shown by their reduced abdominal fattiness); although plasma concentrations of triglycerides were normal, unusual correlations between plasma triglycerides, E2 basal concentrations and body weight were recorded.