The role of histology in the diagnosis of spondylodiscitis: correlation with clinical and microbiological findings

The Bone & Joint Journal
E IwataN A Athanasou

Abstract

The aim of this study was to determine the diagnostic utility of histological analysis in spinal biopsies for spondylodiscitis (SD). Clinical features, radiology, results of microbiology, histology, and laboratory investigations in 50 suspected SD patients were evaluated. In 29 patients, the final (i.e. treatment-based) diagnosis was pyogenic SD; in seven patients, the final diagnosis was mycobacterial SD. In pyogenic SD, the neutrophil polymorph (NP) infiltrate was scored semi-quantitatively by determining the mean number of NPs per (×400) high-power field (HPF). Of the 29 pyogenic SD patients, 17 had positive microbiology and 21 positive histology (i.e. one or more NPs per HPF on average). All non-SD patients showed less than one NP per HPF. The presence of one or more NPs per HPF had a diagnostic sensitivity of 72.4%, specificity 100%, accuracy 100%, positive predictive value (PPV) 81.0%, and negative predictive value (NPV) 61.9%. Sensitivity, specificity, and accuracy were greater using the criterion of positive histology and/or microbiology than positive histology or microbiology alone. Granulomas were identified histologically in seven mycobacterial SD patients, and positive microbiology was detected in four. The diagnosi...Continue Reading

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Citations

Dec 19, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Fardad T AfshariWilliam B Lo
Oct 14, 2020·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Yurina OgawaMichiie Sakamoto

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