Can imaging modalities be used as follow-up criteria after brucellar sacroiliitis treatment?

J Infect Dev Ctries. 2017 Feb 28;11(2):123-128. doi: 10.3855/jidc.6599.

Abstract

Introduction: This study aimed to identify a follow-up modality that can be used to evaluate therapeutic responses in patients receiving treatment for brucellar sacroillitis and to determine whether antibiotherapy can be stopped.

Methodology: A total of 32 patients with sacroiliac joint involvement demonstrated via magnetic resonance imaging or bone scintigraphy were followed up and treated. Patients received 200 mg/day of doxycycline and 600-900 mg/day of rifampicin for 3-21 months, and 1 g/day of streptomycin for 21 days.

Results: The mean age of the 32 patients involved was 21.81±4.09. In total, 10/32 patients did not complete therapy, and the remaining 22 patients received combination antibiotic treatment for a mean of 8.95±4.34 months. Of the 22 patients, 15 underwent MRI, and 7 of them did not consent to MRI. Similarly, 17 patients were followed up by bone scintigraphy, and 5 patients did not have scintigraphy results. In 9/17 patients followed up with bone scintigraphy, sacroiliitis findings were found to reduce after a mean of 7.44±3.71 months, whereas in 12/15 patients on whom MRI was performed, there were no active sacroiliitis findings for a mean of 6.95±2.83 months.

Conclusions: While active involvement findings in bone scintigraphy were observed for a longer period in scintigraphy images, active sacroiliitis findings disappeared in a relatively shorter period of time with MRI. Therefore, we have demonstrated that high-resolution MRI is a very sensitive technique compared to scintigraphy.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage*
  • Brucellosis / diagnostic imaging*
  • Brucellosis / drug therapy
  • Doxycycline / administration & dosage
  • Drug Monitoring / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Radionuclide Imaging / methods*
  • Retrospective Studies
  • Rifampin / administration & dosage
  • Sacroiliitis / diagnostic imaging*
  • Sacroiliitis / drug therapy*
  • Streptomycin / administration & dosage
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Doxycycline
  • Rifampin
  • Streptomycin