ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2022
MRI in differential diagnosis between tuberculous and pyogenic spondylodiscitis.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Magnetic resonance imaging features for differentiating tuberculous from pyogenic spondylitis: a meta-analysis.Skeletal radiology · 2024Pooled it
- Recommendations of the International Consensus Meeting (ICM) 2025 on Spinal Infections: Part B Tubercular Spondylodiscitis.Global spine journal · 2026Article
- Differentiating Tuberculous and Pyogenic Spondylodiscitis: Part II: MRI/CT Features, Prediction Models, and the Role of PET/CT-A Narrative Review.Diagnostics (Basel, Switzerland) · 2026Review
- Novel MRI-based quantitative signal-intensity ratio scores for differentiation of pyogenic and tuberculous spondylitis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Development and validation of a nomogram for differential diagnosis of pyogenic spondylitis and tuberculous spondylitis in China: a multicenter retrospective study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Successful management of Pott's disease in a young woman with 32 weeks of pregnancy: a rare case report.Radiology case reports · 2026Article
- Clinical, laboratory, and MRI features differentiating tuberculous and pyogenic spondylodiscitis: a propensity score-matched analysis.BMC pulmonary medicine · 2026Article
- Tuberculous Spondylodiscitis with Sacroiliac Joint Involvement.Revista da Sociedade Brasileira de Medicina Tropical · 2026Article
- Imaging clues for the diagnosis of various pathogenic causes of infectious spondylitis.Skeletal radiology · 2025Review
- An imaging-based clinical prediction model to differentiate brucellar spondylitis from pyogenic spondylitis: a multicenter retrospective observational study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Observational
- [Spondylitis and spondylodiscitis].Radiologie (Heidelberg, Germany) · 2025Review
- Development of a deep learning-based MRI diagnostic model for human Brucella spondylitis.Biomedical engineering online · 2025Article
- Surgical treatment of unstable spondylodiscitis with posterior instrumentation and bioactive glass (BAG-S53P4): surgical technique and results at medium-term follow-up.Journal of spine surgery (Hong Kong) · 2025Article
- Spondylodiscitis of the thoraco-lumbar spine: diagnostic performance of dual-energy CT vs MRI.European radiology · 2025Article
- Current knowledge of vertebral osteomyelitis: a review.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Review
- The Never Ending Story-What Are the Differentiable Magnetic Resonance Imaging Characteristics Between Pyogenic and Mycobacterial Thoracolumbar Infections?Journal of clinical medicine · 2025Article
- A Comparative Factor Analysis and New Magnetic Resonance Imaging Scoring System for Differentiating Pyogenic Versus Tuberculous Spondylodiscitis.Neurospine · 2024Article
- Imaging of Spondylodiscitis: A Comprehensive Updated Review-Multimodality Imaging Findings, Differential Diagnosis, and Specific Microorganisms Detection.Microorganisms · 2024Review
- Differentiation of Native Vertebral Osteomyelitis: A Comprehensive Review of Imaging Techniques and Future Applications.Medical science monitor : international medical journal of experimental and clinical research · 2024Review
- Application of metagenomic next-generation sequencing for rapid molecular identification in spinal infection diagnosis.Frontiers in cellular and infection microbiology · 2024Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of the study was to investigate whether MRI findings together with epidemiological data could help in differentiating between tuberculous and pyogenic spondylodiscitis.
methodsClinical records of 260 patients with a suspicion of spondylodiscitis were analysed. Patients were selected using the following inclusion criteria: confirmed diagnosis of spondylodiscitis either from pyogenic bacteria or from Mycobacterium tuberculosis and contrast-enhanced MRI performed before treatment. Clinical data concerning age, sex and country-of-origin were also collected. For each patient, several MRI-features were evaluated by two-expert musculoskeletal radiologists. A chi-squared test and a multiple logistic regression were used to find the best predictors of tuberculous or pyogenic spondylodiscitis.
results114 patients were retrospectively enrolled, 30 with tuberculous and 84 with pyogenic spondylodiscitis. We found 18 MRI-features, significantly different between the two groups. Among these, the most strongly associated with tuberculous spondylodiscitis were: heterogeneous vertebral signal on T1w-sequences (Odds Ratio(OR) = 205.759-p < 0.001), presence of epidural abscess (OR = 86.221-p < 0.001), severe vertebral destruction (OR = 10.017-p < 0.001) and absence of epidural phlegmon (OR = 86.221-p < 0.001). Moreover, patients coming from countries with a middle-high prevalence of tuberculosis were more frequently affected by tuberculous spondylodiscitis than others were (OR = 229.136-p < 0.001). The best prediction model demonstrated a correct classification rate of 94.7%.
conclusionTo the best of our knowledge this is the largest study comparing MRI-features of tuberculous and pyogenic spondylodiscitis. The above-mentioned MRI-features and epidemiological data are crucial in the differential diagnosis between these two entities, guiding the choice of the appropriate therapy, especially when a pathogen cannot be clearly identified with other modalities.
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