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4. Primary extrahepatic alveolar echinococcosis of the lumbar spine and the psoas muscle

Author

Gradinger Reiner, da Costa Clarissa, Trappe Dennis, Schaeffeler Christoph, von Eisenhart-Rothe Rüdiger, Gradl Guntmar, Burgkart Rainer H, Nell Manuel, and Kirchhoff Chlodwig

Subjects
Therapeutics. Pharmacology, RM1-950, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

Abstract Alveolar echinococcosis (AE) of human being caused by Echinococcus multilocularis is a rare but important zoonosis especially in tempered zones of middle Europe and Northern America with endemic character in many countries. Due to the long incubation period, various clinical manifestations, critical prognosis, and outcome AE presents a serious and severe disease. The primary focus of infection is usually the liver. Although secondary affection of visceral organs is possible extrahepatic AE is highly uncommon. Moreover, the involvement of bone and muscle presents with an even lower incidence. In the literature numerous cases on hepatic AE have been reported. However, extrahepatic AE involving bones and/or muscles was described very rarely. We report a case of an 80-year-old man with primary extrahepatic alveolar Echinococcosis of the lumbar spine and the psoas muscle. The etiology, diagnosis, differential diagnoses, treatment options and outcome of this rare disease are discussed in context with the current literature.

Published
2011
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6. Spontaneous Septic Arthritis of Pubic Symphysis in an Elite Athlete

Author

Smits, F. Jasmijn, Frima, Herman, Schaeffeler, Christoph, and Sommer, Christoph

Subjects
Article Subject
Abstract

Septic arthritis of the pubic symphysis is a potentially severe disease. Athletes are at risk of this form of spontaneous arthritis, as inflammation of the pubic bone due to muscular stress is relatively common. Oedema due to inflammation might predispose to infection through bacteraemia or local bacterial translocation. Suspicion should be raised when an athlete complains of groin pain and has signs of infection (i.e., fever, elevated white blood cell count, and elevated C-reactive protein). Diagnosis is made by imaging showing signs of inflammation combined with positive (blood) cultures. Broad spectrum antibiotics should be started upon suspicion and adjusted according to cultures. An abscess causing clinical deterioration under antibiotic treatment is an indication for invasive intervention (i.e., surgical or image-guided drainage). This is the first case of spontaneous septic arthritis of the pubic symphysis in an athlete requiring surgical and additional image-guided drainage.

Published
2016
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9. View-Angle Tilting and Slice-Encoding Metal Artifact Correction for Artifact Reduction in MRI: Experimental Sequence Optimization for Orthopaedic Tumor Endoprostheses and Clinical Application

Author

Jungmann, Pia M., primary, Ganter, Carl, additional, Schaeffeler, Christoph J., additional, Bauer, Jan S., additional, Baum, Thomas, additional, Meier, Reinhard, additional, Nittka, Mathias, additional, Pohlig, Florian, additional, Rechl, Hans, additional, von Eisenhart-Rothe, Ruediger, additional, Rummeny, Ernst J., additional, and Woertler, Klaus, additional

Published
2015
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10. Evaluation of 18F-Fluoride PET/MR and PET/CT in Patients with Foot Pain of Unclear Cause

Author

Rauscher, Isabel, primary, Beer, Ambros J., additional, Schaeffeler, Christoph, additional, Souvatzoglou, Michael, additional, Crönlein, Moritz, additional, Kirchhoff, Chlodwig, additional, Sandmann, Gunther, additional, Fürst, Sebastian, additional, Kilger, Robert, additional, Herz, Michael, additional, Ziegler, Sybille, additional, Schwaiger, Markus, additional, and Eiber, Matthias, additional

Published
2015
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11. Magnetic resonance perfusion and diffusion imaging characteristics of transient bone marrow edema, avascular necrosis and subchondral insufficiency fractures of the proximal femur

Author

Mueller, Dirk, Schaeffeler, Christoph, Baum, Thomas, Walter, Flavia, Rechl, Hans, Rummeny, Ernst J., Woertler, Klaus, Mueller, Dirk, Schaeffeler, Christoph, Baum, Thomas, Walter, Flavia, Rechl, Hans, Rummeny, Ernst J., and Woertler, Klaus

Abstract

Purpose: To evaluate magnetic resonance (MR) perfusion and diffusion imaging characteristics in patients with transient bone marrow edema (TBME), avascular necrosis (AVN), or subchondral insufficiency fractures (SIF) of the proximal femur. Materials and methods: 29 patients with painful hip and bone marrow edema pattern of the proximal femur on non-contrast MR imaging were examined using diffusion-weighted and dynamic gadolinium-enhanced sequences. Apparent diffusion coefficients (ADCs) and perfusion parameters were calculated for different regions of the proximal femur. Regional distribution and differences in ADC values and perfusion parameters were evaluated. Results: Seven patients presented with TBME, 15 with AVN and seven with SIF of the proximal femur. Perfusion imaging showed significant differences for maximum enhancement values (E-max), slope (E-slope) and time to peak (TTP) between the three patient groups (p < 0.05). In contrast, no significant differences for ADC values were calculated when comparing TBME, AVN, and SIF patients. Conclusion: Diffusion weighted imaging of bone marrow of the proximal femur did not show significant differences between patients with TBME, AVN or SIF. In contrast, MR perfusion imaging demonstrated significant differences for the different patient groups and may as a complementary imaging technique add information to the understanding of the pathophysiology of diseases associated with bone marrow edema. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

Published
2014

14. Spontaneous Septic Arthritis of Pubic Symphysis in an Elite Athlete

Author

Jasmijn Smits, F., Frima, Herman, Schaeffeler, Christoph, and Sommer, Christoph

Abstract

Septic arthritis of the pubic symphysis is a potentially severe disease. Athletes are at risk of this form of spontaneous arthritis, as inflammation of the pubic bone due to muscular stress is relatively common. Oedema due to inflammation might predispose to infection through bacteraemia or local bacterial translocation. Suspicion should be raised when an athlete complains of groin pain and has signs of infection (i.e., fever, elevated white blood cell count, and elevated C-reactive protein). Diagnosis is made by imaging showing signs of inflammation combined with positive (blood) cultures. Broad spectrum antibiotics should be started upon suspicion and adjusted according to cultures. An abscess causing clinical deterioration under antibiotic treatment is an indication for invasive intervention (i.e., surgical or image-guided drainage). This is the first case of spontaneous septic arthritis of the pubic symphysis in an athlete requiring surgical and additional image-guided drainage.

Published
2016
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