Abstract: Aim: was to demonstrate possibilities of timely radiological diagnosis and treatment of spinal tuberculosis in a patient with a single lung after pleuropneumonectomy for fibrocavernous pulmonary tuberculosis. Materials and methods: patient, 26 y.o. female, country inhabitant, grocery store clerk. She was hospitalized to the National Medical Research Center for Phthisiopulmonology and Infectious Diseases of the Ministry of Health of the Russian Federation with a diagnosis: “Tuberculosis spondylitis Th12-L2, focal tuberculosis S2 of the single right lung in the infiltration phase. M.Tb(-). Pleuropneumonectomy for fibrocavernous tuberculosis of left lung (December 18, 2018)”. To clarify etiology and lesion volume and to determine surgical treatment tactics, multispiral computed tomography (MSCT) of lungs and thoracolumbar spine and subsequent percutaneous trephine biopsy of the L1 vertebra were performed. Results: according to MSCT data, destruction of Th12-L1-2 vertebral bodies was revealed; in single right lung, medium-intensity focal lesion with a diameter of 5 mm in C1, a small calcinate in C2, and a subpleural focal lesion in C4 were visualized. Small-focal dissemination was observed throughout the entire length of single lung. Bacteriological study of biological material taken during trephine biopsy revealed the growth of Mycobacterium tuberculosis, confirmed by diagnostics of polymerase chain reaction (PCR). Taking into account the pulmonary pathology, operation was performed in the volume of resection of Th12-L1-2 bodies and antero-lateral spinal fusion with a Mesh body replacement implant with bone autoplasty from left-side access, transpedicular fixation (TPF) of Th11-L3 with a four-screw structure under intraoperative radiation control. As a result of treatment, patient was discharged in a satisfactory condition. Conclusions: presented case report demonstrates the importance of timely radiological diagnosis in patients with combined infectious lesions of lungs and spine for obtaining of complete information about the state of respiratory and bone systems, using MSCT and interventional radiology methods and for determination of pathological process etiology. It made it possible to perform timely diagnosis and complex surgical intervention with the most sparing and light surgical access to affected vertebrae in tuberculosis spondylitis from the side of previous pleuropneumonectomy. References 1. Giller DB, Martel’ II, Imagozhev YG, et al. An experience of single lung resection and pneumonectomy after contralateral lung resection in treatment of tuberculosis. Khirurgiya (Mosk). 2021; (1): 15-21 [In Russ]. https://doi.org/10.17116/hirurgia2015935-42 2. Giller DB, Giller GV, Imagozhev YG. Surgical collapse in the treatment of single lung tuberculosis. Khirurgiia. 2021; (1): 15-21 [In Russ]. https://doi.org/10.17116/hirurgia202101115 3. Mushkin AYu, Vishnevskiy AA, Peretsmanas EO, et al. Infectious Lesions of the Spine: Draft National Clinical Guidelines. Khirurgiya pozvonochnika. 2019; 16(4): 63-76 [In Russ]. https://doi.org/10.14531/ss2019.4.63-76 4. Sovetova NA, Vasileva GYu, Soloveva NS. Tuberculous spondylitis in adults (clinical and radiographic manifestation). Tuberkulez I bolezni legkikh. 2014; (10): 33-37 [In Russ]. 5. Dunn RN, Ben Husien M. Spinal tuberculosis: review of current management. Bone Joint J. 2018; 1(100-B(4)): 425-431.
ABSTRACT: Article presents a literature review on the role of magnetic resonance imaging (MRI) of sacroiliac joints in the diagnosis of ankylosing spondylitis. Aim: was to analyze domestic and foreign literature sources that reflect the state of the problem and aspects of radiodiagnostics of sacroiliac joints in patients with ankylosing spondylitis. Materials and methods: article contains analysis of 29 literature sources of leading domestic and foreign scientific journals. Results: for a reliable diagnosis of ankylosing spondylitis, the presence of x-ray confirmed sacroiliitis is a prerequisite. However, difficulties in confirming or absence of sings of sacroiliitis on radiography at the beginning of the disease leads to a delay in the diagnosis of ankylosing spondylitis, which is established for 5-10 years after first clinical signs of the disease. Magnetic resonance imaging allows us to evaluate changes in sacroiliac joints in early stages of the disease and prevent the development of significant structural changes that lead to early disability of patients. MR-symptoms of active inflammation of sacroiliac joints in ankylosing spondylitis include: edema of the bone marrow (ostitis) in subchondral parts of iliac bones and sacrum, edema of the capsule (capsulitis) and periarticular ligaments (enteritis) joint, as well as synovitis, accompanied by synovial effusion into the joint cavity. MR-symptoms of structural changes in sacroiliac joints in ankylosing spondylitis include: bone erosion, sclerosis, fat deposits of the bone marrow, bone bridges, ankyloses. Conclusion: magnetic resonance imaging currently occupies a leading position in the early diagnosis of ankylosing spondylitis, which allows us to identify active inflammatory and structural changes in sacroiliac joints. References 1. Jerdes ShF, Rebrov AP, Dubinina TV et al. 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