title: Scintigraphic findings in osteoarticular brucellosis.
abstract: OBJECTIVE
  To describe the distribution of bone and joint involvement in 197 patients with brucellosis, and to detail a spectrum of findings on bone scintigraphy in 38 patients with brucellar spondylitis.
  
  
  METHODS
  One hundred and ninety-seven patients (141 females, 56 males; age range, 5-77 years) with osteoarticular brucellosis were studied. Patients were classified into acute (62%) and chronic (38%) stages of the disease, and into age groups of less than 16 (1%), 16-30 (17%), 31-45 (29%), 46-60 (37%) and over 60 (16%) years. All patients were evaluated with Tc-methylene diphosphonate bone scanning. Quantification of sacroiliac joint uptake was performed to improve the sensitivity for the detection of sacroiliitis. Plain radiography and computed tomography (CT) or magnetic resonance imaging (MRI) were performed, when required, to evaluate the areas of the skeleton that showed abnormal uptake on the bone scan. MRI and single photon emission computed tomography (SPECT) were performed in all patients who had spinal lesions.
  
  
  RESULTS
  The sites most commonly affected were the sacroiliac joints (53%) and spine (19%), followed by the shoulders (16%). Osteoarticular involvement was more common in females (72%) than in males (28%), and the acute stage (62%) was observed more than the chronic stage (38%). Bone and joint involvement occurred at any age, but the most common age group was 46-60 years. Eight scintigraphic patterns were identified in spinal involvement.
  
  
  CONCLUSIONS
  Brucellosis may affect the musculoskeletal system at any site. Bone scan is a useful method to detect osteoarticular involvement in cases of relapse and progression. Spine involvement has the widest range of scintigraphic findings. A knowledge of the location and distribution of osteoarticular involvement as revealed on the bone scan of patients with brucellosis may be valuable in patient treatment and management.
authors.affiliation: Department of Nuclear Medicine, Baskent University, Ankara, Turkey. maydin@dr.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aydin
authors.forename: A
authors.initials: A
authors.lastname: Fuat Yapar
authors.forename: Lutfu
authors.initials: L
authors.lastname: Savas
authors.forename: Mehmet
authors.initials: M
authors.lastname: Reyhan
authors.forename: Aysin
authors.initials: A
authors.lastname: Pourbagher
authors.forename: Tuba Yeter
authors.initials: TY
authors.lastname: Turunc
authors.forename: Y
authors.initials: Y
authors.lastname: Ziya Demiroglu
authors.forename: Nazli Altun
authors.initials: NA
authors.lastname: Yologlu
authors.forename: Ayse
authors.initials: A
authors.lastname: Aktas
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001170:Arthritis, Infectious / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D001850:Bone Diseases, Infectious / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002006:Brucellosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011877:Radionuclide Imaging; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D014421:Turkey / Q000453:epidemiology