IMAGING FEATURES OF MUSCULOSKELETAL BRUCELLOSIS

Brucellosis is endemic in certain parts of the world. Musculoskeletal involvement is the most common complication of brucellosis, and the sp ine is most frequently affected. Between November 1985 and March 1933, 334 patients with radiologically proved musculoskeletal brucellosis w ere seen. Involvement of the spine was either focal or diffuse, with a predilection to the lumbar region. Erosions and sclerosis in vertebra l end plates, changes of inflammation at scintigraphy or magnetic reso nance (MR) imaging, and intact disks were hallmarks of the focal form. Osteomyelitis of neighboring vertebrae, involvement of the intervenin g disk, and moderate epidural. extension were features of diffuse bruc ellar spondylitis. The great majority of joints with scintigraphic evi dence of disease demonstrated normal radiographic findings. Evidence o f osteomyelitis or destructive arthritis was encountered in only a few cases. Although radiography is sufficient for demonstrating focal bru cellosis, MR imaging is better for assessing diffuse disease.