Musculoskeletal ImagingActinomycosis
a noncontagious infectious disease caused predominantly by
Actinomyces israelii in humans. Actinomycosis is characterized by lymphadenitis of the cervicofacial area (lumpy jaw) and intraperitoneal and pelvic abscesses. Debilitated persons or devitalized tissues are particularly prone to involvement.
Trauma is important in the introduction of the organisms into tissues. Haematogenous dissemination of organisms from infective foci in the face, lung or bowel can lead to contamination of subcutaneous tissues, bones, joints or other tissues (liver, spleen, kidneys, brain). For a general description, see
actinomycosis.
Skeletal sites usually become contaminated from an adjacent infected soft tissue focus, although less frequently haematogenous seeding of bone or joint tissues occurs. The bones most frequently involved are the mandible, the flat bones of the axial skeleton and the major joints of the appendicular skeleton. Osseous involvement is characterized by a combination of lysis and sclerosis (Fig.1). In the ribs, concurrent findings of severe bone eburnation, cutaneous sinus tracts and pleuritis are suggestive of actinomycosis. In the vertebral column, infection can originate from adjacent mediastinal or retroperitoneal foci, and paravertebral abscesses may be seen.
DR/RB
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AP radiograph of the hand demonstrates extensive osteolysis of the middle finger and marked soft tissue deformity in this diabetic patient.
(Courtesy of Richard Taketa, MD, Corona del Mar, California)
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Actinomycosis, Fig.1 | |