ABSTRACT
This is a report of an isolated septic arthritis of a lumbar facet joint where the infectious agent was Bacteroides sp. and where an early diagnosis was made using MRI.
Subject(s)
Arthritis, Infectious/diagnosis , Bacteroides Infections/diagnosis , Lumbar Vertebrae , Zygapophyseal Joint , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/complications , Arthritis, Infectious/drug therapy , Bacteroides Infections/complications , Bacteroides Infections/drug therapy , Clindamycin/therapeutic use , Diagnosis, Differential , Drug Therapy, Combination/therapeutic use , Female , Humans , Inhalation , Low Back Pain/microbiology , Magnetic Resonance Imaging/standards , Middle Aged , Recurrence , Sensitivity and Specificity , Treatment OutcomeABSTRACT
UNLABELLED: To evaluate clinical, radiologic, and laboratory features in Lebanese spondylarthropathy patients according to HLA-B27 status. METHODS: We retrospectively compared demographic, clinical, radiologic, and severity data in 40 HLA-B27-positive and 58 HLA-B27-negative patients. All 98 patients met Amor's or European Spondylarthropathy Study Group criteria for spondylarthropathy, and 51.7% met New York modified criteria for ankylosing spondylitis. RESULTS: Onset before 16 years of age, hip involvement, and an elevated mean erythrocyte sedimentation rate were significantly associated with the presence of the HLA-B27 (32.5 vs 13.8%, P=0.02; 45 vs 7.5%, P=0.001; and 47.7 vs 25.4, P=0.02; respectively). The two groups were comparable for age, sex ratio, prevalence and distribution of spondylarthropathy types, family history, sacroiliitis, bamboo spine, syndesmophytes, peripheral joint involvement, enthesopathies, extra-articular involvement, response to nonsteroidal anti-inflammatory drugs, and need for other medications. CONCLUSION: In Lebanon, spondylarthropathy patients positive for HLA-B27 experience disease onset at an earlier age, are more likely to develop hip involvement, and have laboratory evidence of more severe inflammation than their HLA-B27-negative counterparts. None of the other clinical and radiologic parameters are modified by HLA-B27 status.
