Diagnosing pelvic @entity6227 in spinal cord injured XXXX : a prospective study.

@entity1 @entity796 @entity795 @entity4034 @entity1066 @entity2348 @entity794 @entity6227
UNASSIGNED: There is no consensus on a diagnostic strategy for @entity4034 underlying @entity6227 . We conducted a prospective study to assess the accuracy of multiple bone biopsies and imaging to diagnose pelvic @entity4034 . @entity1 with clinically suspected @entity4034 beneath pelvic @entity6227 were enrolled. Bone magnetic resonance imaging (MRI) and surgical bone biopsies (three or more for microbiology and one for histology per @entity1066 ) were performed. @entity2348 diagnosis relied upon the association of positive histology and microbiology (at least one positive culture for non-commensal microorganisms or three or more for commensal microorganisms of the skin). From 2011 to 2014, 34 @entity1 with 44 @entity6227 were included. @entity2348 was diagnosed for 28 (82.3%) @entity1 and 35 (79.5%) @entity1066 according to the composite criterion. Discrepancy was observed between histology and microbiology for 5 (11.4%) @entity1066 . Most common isolates were @entity794 (77.1%), Peptostreptococcus (48.6%) and Bacteroides (40%), cultured in three or more samples in 42.9% of @entity1066 for @entity794 and >= 20% for anaerobes. Only 2.8% of @entity1066 had three or more positive specimens with coagulase-negative staphylococci, group B Streptococcus, and nil with enterococci and @entity796 . @entity794 , @entity795 and group milleri Streptococcus were recovered from one sample in 22.8%, 11.4% and 11.4% of @entity1066 , respectively. Agreement was poor between biopsies and MRI (k 0.2). Sensitivity of MRI was 94.3% and specificity was 22.2%. The diagnosis of pelvic @entity4034 relies on multiple surgical bone biopsies with microbiological and histological analyses. At least three bone samples allows the detection of pathogens and exclusion of contaminants. MRI is not routinely useful for diagnosis.
