Aspects Tomodensitometriques des Infections Rachidiennes dans le Service dâ€™Imagerie Medicale du CNHU-HKM a Cotonou (Benin)
Authors: Adjadohoun Sonia, Bignon Mahussi Gwladys , Yekpe Ahouansou Patricia , Ngamo Gabriel , Brigitte Kuye-Ndongo , Anita Baglo , Kofi-Mensa Savi De Tove , Zavier Zomalheto , Olivier Biaou 
Published: June 2021

Introduction : Les atteintes infectieuses du rachis (AIR) sont rares, mais en recrudescence en raison des affections immunodÃ©pressives et immunosuppressives. Elles reprÃ©sentent 4 Ã 7 % de toutes les ostÃ©omyÃ©lites. Au Centre National Hospitalier Universitaire Hubert Koutoukou Maga (CNHU HKM) de Cotonou (BÃ©nin), elles constituent 2,31% des hospitalisations. Lâ€™objectif de ce travail Ã©tait de dÃ©crire leurs caractÃ©ristiques tomodensitomÃ©triques. MatÃ©riels et mÃ©thode : Ã‰tude transversale descriptive aÌ€ collecte rÃ©trospective menÃ©e dans le service dâ€™imagerie mÃ©dicale du CNHUHKM sur une pÃ©riode de six (06) ans allant du 1er Janvier 2012 au 31 DÃ©cembre 2017. Portant sur les comptes rendus de scanner oÃ¹ le diagnostic dâ€™AIR avait Ã©tÃ© retenu. Les examens tomodensitomÃ©triques avaient Ã©tÃ© rÃ©alisÃ©s aÌ€ lâ€™aide dâ€™un Scanner Siemens Somatom Emotionïƒ¢ (16 barrettes modÃ¨le 2011). RÃ©sultats : Sur 2797 scanners du rachis, 140 AIR (3,5%) avaient Ã©tÃ© suspectÃ©es et 72 (2.6%) avaient Ã©tÃ© confirmÃ©es sur les images scanographiques. Lâ€™aÌ‚ge moyen Ã©tait de 49,98 ans Â± 15,5 ans avec une prÃ©dominance masculine (sex ratio= 1,2). Le segment de prÃ©dilection Ã©tait lombaire (77,8%) avec des Ã©rosions en miroir (11,12 %) principalement au niveau de lâ€™Ã©tage L3-L4 (12.5%). Une hypodensitÃ©Ìdiscale Ã©tait retrouvÃ©e dans 16.7% des cas. Lâ€™atteinte somatique la plus frÃ©quente Ã©tait lâ€™ostÃ©ocondensation (20,8%). Les tassements vertÃ©braux Ã©taient observÃ©s dans 9.72% et les listhÃ©sis dans 11.11% des cas. Les diagnostics de discite, de spondylite, et de spondylodiscite avaient Ã©tÃ© retenus respectivement dans 6,94%, 8,33% et 84,72 % des cas. Une extension aux parties molles Ã©tait retrouvÃ©e dans 27,8 % des cas dont un abceÌ€s des parties molles dans 22,22% des cas. Conclusion : Au dÃ©cours de cette Ã©tude, le diagnostic des AIR bien que tardif, a majoritairement Ã©tÃ© posÃ© au scanner avant la survenue de complications. Les Ã©rosions en miroir des spondyles Ã©taient fortement Ã©vocatrices en dehors de toute hypodensitÃ©Ì discale.

Introduction: Infections of the spine (AIR) are rare but increase because of immunosuppressive and immunosuppressive disorders. They represent 4 to 7% of all osteomyelitis. At the Hubert Koutoukou Maga National University Hospital Center (CNHU HKM), they constitute 2.31% of hospitalizations. The aim of this work is to describe their CT characteristics at the CNHU-HKM in Cotonou. Material and method: Retrospective descriptive cross-sectional study conducted of the CNHU-HKM medical imaging department over a period of 06 years from January 1, 2012 to December 31, 2017. Included were all CT scan reports where the diagnosis was made AIR had been retained. Computed tomographic examinations were performed using a Siemens Somatom EmotionÂ® Scanner (16 slices model 2011). Results: Of 2,797 spine scans, 140 IRAs were suspected and 72 (2.6%) were diagnosed on the scanographic images. The average age was 49.98 Â± 15.5 years with a male predominance (sex ratio = 1.2). The preferred segment was lumbar (77.8%) with mirror erosions (11.12%) mainly at the L3-L4 stage (12.5%). A disc hypodensity was found in 16.7% of cases. The most common somatic involvement was osteocondensation (20.8%). Vertebral compression was observed in 9.72% and listhesis in 11.11% of cases. Diagnoses of discitis, spondylitis, and spondylodiscitis were retained in 6.94%, 8.33% and 84.72% of cases, respectively. Soft tissue extension was found in 27.8% of cases including soft tissue abscess in 22.22% of cases. Conclusion: During the course of this study, the diagnosis of RIA, although late, was mainly performed on CT before the occurrence of complications. The mirrored erosions of the spondyls were strongly evocative outside of any disc hypodensity.