Can Hematological Inflammatory Indices Be Used to Differentiate Modic Type 1 Changes from Brucella Spondylodiscitis?
Abstract
:1. Introduction
2. Materials and Methods
2.1. The Inclusion Criteria
2.2. The Exclusion Criteria
3. Results
3.1. Comparison of the Groups in Age, Gender, Pain Duration, CRP, ESR, and Spinal Levels
3.2. Comparison of the Groups in Complete Blood Cells
3.3. Comparison of the Groups in HII
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Dudli, S.; Fields, A.J.; Samartzis, D.; Karppinen, J.; Lotz, J.C. Pathobiology of Modic changes. Eur. Spine J. 2016, 25, 3723–3734. [Google Scholar] [CrossRef] [PubMed]
- Alpaycı, M.; Bulut, M.D.; Yazmalar, L.; Yavuz, A.; Toprak, M.; Koparan, İ.H.; Gülşen, İ. The relationship between facet joint osteoarthritis and Modic changes of the lumbar spine: A retrospective magnetic resonance imaging study. Turk. J. Phys. Med. Rehab 2016, 62, 308–313. [Google Scholar] [CrossRef]
- Perilli, E.; Parkinson, I.H.; Truong, L.-H.; Chong, K.C.; Fazzalari, N.L.; Osti, O.L. Modic (end-plate) changes in the lumbar spine: Bone microarchitecture and remodelling. Eur. Spine J. 2014, 24, 1926–1934. [Google Scholar] [CrossRef] [PubMed]
- Teraguchi, M.; Hashizume, H.; Oka, H.; Cheung, J.P.Y.; Samartzis, D.; Tamai, H.; Muraki, S.; Akune, T.; Tanaka, S.; Yoshida, M.; et al. Detailed Subphenotyping of Lumbar Modic Changes and Their Association with Low Back Pain in a Large Population-Based Study: The Wakayama Spine Study. Pain. Ther. 2022, 11, 57–71. [Google Scholar] [CrossRef] [PubMed]
- Czaplewski, L.G.; Rimmer, O.; McHale, D.; Laslett, M. Modic changes as seen on MRI are associated with nonspecific chronic lower back pain and disability. J. Orthop. Surg. Res. 2023, 18, 351. [Google Scholar] [CrossRef] [PubMed]
- Slouma, M.; Kharrat, L.; Tezegdenti, A.; Metoui, L.; Ghazouani, E.; Dhahri, R.; Gharsallah, I.; Louzir, B. Pro-inflammatory cytokines in patients with low back pain: A comparative study. Reumatol. Clin. Engl. Ed. 2023, 19, 244–248. [Google Scholar] [CrossRef]
- Albert, H.B.; Kjaer, P.; Jensen, T.S.; Sorensen, J.S.; Bendix, T.; Manniche, C. Modic changes, possible causes and relation to low back pain. Med. Hypotheses 2008, 70, 361–368. [Google Scholar] [CrossRef]
- Crockett, M.T.; Kelly, B.S.; van Baarsel, S.; Kavanagh, E.C. Modic Type 1 Vertebral Endplate Changes: Injury, Inflammation, or Infection? Am. J. Roentgenol. 2017, 209, 167–170. [Google Scholar] [CrossRef]
- Delen, V.; Alpayci, M. Brucellosis in patients with inflammatory modic changes: Results from cross-sectional and case–control comparisons. SN Compr. Clin. Med. 2022, 4, 238. [Google Scholar] [CrossRef]
- Heggli, I.; Mengis, T.; Laux, C.J.; Opitz, L.; Herger, N.; Menghini, D.; Schuepbach, R.; Farshad-Amacker, N.A.; Brunner, F.; Fields, A.J.; et al. Low back pain patients with Modic type 1 changes exhibit distinct bacterial and non-bacterial subtypes. Osteoarthr. Cartil. Open 2024, 6, 100434. [Google Scholar] [CrossRef]
- Dudli, S.; Liebenberg, E.; Magnitsky, S.; Lu, B.; Lauricella, M.; Lotz, J.C. Modic type 1 change is an autoimmune response that requires a proinflammatory milieu provided by the ‘Modic disc’. Spine J. 2018, 18, 831–844. [Google Scholar] [CrossRef] [PubMed]
- Rammeh, S.; Romdhane, E.; Riahi, H.; Ksentini, M.; Chelli Bouaziz, M.; Ayadi, R.; Berriche, A.; Chebbi, Y.; Ladeb, M.F. Brucellar spondylodiscitis: A case series with focus on histopathological features. J. Clin. Neurosci. 2020, 78, 360–364. [Google Scholar] [CrossRef] [PubMed]
- Priya, P.; Solomon, P.; Nair, S.; Mohankumar, P. An Uncommon Case of Brucellar Spondylodiscitis: A Case Report. J. Orthop. Case Rep. 2022, 12, 10–14. [Google Scholar] [CrossRef] [PubMed]
- Spernovasilis, N.; Karantanas, A.; Markaki, I.; Konsoula, A.; Ntontis, Z.; Koutserimpas, C.; Alpantaki, K. Brucella Spondylitis: Current Knowledge and Recent Advances. J. Clin. Med. 2024, 13, 595. [Google Scholar] [CrossRef] [PubMed]
- Esmaeilnejad-Ganji, S.M.; Esmaeilnejad-Ganji, S.M.R. Osteoarticular manifestations of human brucellosis: A review. World J. Orthop. 2019, 10, 54–62. [Google Scholar] [CrossRef] [PubMed]
- Roushan, M.R.H.; Ebrahimpour, S.; Afshar, Z.M.; Babazadeh, A. Cervical Spine Spondylitis with an Epidural Abscess in a Patient with Brucellosis: A Case Report. J. Crit. Care Med. Targu Mures 2019, 5, 103–106. [Google Scholar] [CrossRef] [PubMed]
- Ali Adam, A.; Sheikh Hassan, M.; Adam Osman, A. Spinal brucellosis causing spondylodiscitis. Ann. Med. Surg. 2022, 82, 104782. [Google Scholar] [CrossRef] [PubMed]
- Wu, Z.G.; Song, Z.Y.; Wang, W.X.; Xi, W.N.; Jin, D.; Ai, M.X.; Wu, Y.C.; Lan, Y.; Song, S.F.; Zhang, G.C.; et al. Human brucellosis and fever of unknown origin. BMC Infect. Dis. 2022, 22, 868, Erratum in BMC Infect. Dis. 2023, 23, 23. [Google Scholar] [CrossRef]
- Tali, E.T.; Koc, A.M.; Oner, A.Y. Spinal brucellosis. Neuroimaging Clin. N. Am. 2015, 25, 233–245. [Google Scholar] [CrossRef]
- Yang, X.; Zhang, Q.; Guo, X. Value of magnetic resonance imaging in brucellar spondylodiscitis. Radiol. Med. 2014, 119, 928–933. [Google Scholar] [CrossRef]
- Di Bonaventura, G.; Angeletti, S.; Ianni, A.; Petitti, T.; Gherardi, G. Microbiological Laboratory Diagnosis of Human Brucellosis: An Overview. Pathogens 2021, 10, 1623. [Google Scholar] [CrossRef] [PubMed]
- Qureshi, K.A.; Parvez, A.; Fahmy, N.A.; Abdel Hady, B.H.; Kumar, S.; Ganguly, A.; Atiya, A.; Elhassan, G.O.; Alfadly, S.O.; Parkkila, S.; et al. Brucellosis: Epidemiology, pathogenesis, diagnosis and treatment-a comprehensive review. Ann. Med. 2023, 55, 2295398. [Google Scholar] [CrossRef] [PubMed]
- Bozgeyik, Z.; Aglamis, S.; Bozdag, P.G.; Denk, A. Magnetic resonance imaging findings of musculoskeletal brucellosis. Clin. Imaging 2014, 38, 719–723. [Google Scholar] [CrossRef]
- Sayin Kutlu, S.; Kutlu, M.; Tuzun, T.; Ozdemir, K. Spondylodiscitis: A common complication of brucellosis. J. Infect. Dev. Ctries. 2018, 12, 550–556. [Google Scholar] [CrossRef]
- Salaffi, F.; Ceccarelli, L.; Carotti, M.; Di Carlo, M.; Polonara, G.; Facchini, G.; Golfieri, R.; Giovagnoni, A. Differentiation between infectious spondylodiscitis versus inflammatory or degenerative spinal changes: How can magnetic resonance imaging help the clinician? Radiol. Med. 2021, 126, 843–859. [Google Scholar] [CrossRef]
- Schwarz-Nemec, U.; Friedrich, K.M.; Stihsen, C.; Schwarz, F.K.; Trattnig, S.; Weber, M.; Grohs, J.G.; Nemec, S.F. Vertebral Bone Marrow and Endplate Assessment on MR Imaging for the Differentiation of Modic Type 1 Endplate Changes and Infectious Spondylodiscitis. J. Clin. Med. 2020, 9, 826. [Google Scholar] [CrossRef] [PubMed]
- Patel, K.B.; Poplawski, M.M.; Pawha, P.S.; Naidich, T.P.; Tanenbaum, L.N. Diffusion-weighted MRI “claw sign” improves differentiation of infectious from degenerative modic type 1 signal changes of the spine. AJNR Am. J. Neuroradiol. 2014, 35, 1647–1652. [Google Scholar] [CrossRef] [PubMed]
- Zahorec, R. Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratisl. Lek. Listy 2021, 122, 474–488. [Google Scholar] [CrossRef]
- Zinellu, A.; Paliogiannis, P.; Sotgiu, E.; Mellino, S.; Mangoni, A.A.; Zinellu, E.; Negri, S.; Collu, C.; Pintus, G.; Serra, A.; et al. Blood Cell Count Derived Inflammation Indexes in Patients with Idiopathic Pulmonary Fibrosis. Lung 2020, 198, 821–827. [Google Scholar] [CrossRef]
- Ghobadi, H.; Mohammadshahi, J.; Javaheri, N.; Fouladi, N.; Mirzazadeh, Y.; Aslani, M.R. Role of leukocytes and systemic inflammation indexes (NLR, PLR, MLP, dNLR, NLPR, AISI, SIR-I, and SII) on admission predicts in-hospital mortality in non-elderly and elderly COVID-19 patients. Front. Med. 2022, 9, 916453. [Google Scholar] [CrossRef]
- Tanojo, N.; Damayanti Utomo, B.; Ervianti, E.; Murtiastutik, D.; Prakoeswa, C.R.S.; Listiawan, M.Y. Diagnostic Value of Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Diagnosis of Erythema Nodosum Leprosum: A Retrospective Study. Trop. Med. Infect. Dis. 2022, 7, 39. [Google Scholar] [CrossRef] [PubMed]
- Canat, M.M.; Turkkan, C.Y.; Erhan, H.; Ozturk, F.Y.; Altuntas, Y. The Role of Serum Inflammation-Based Scores in Diagnosis and Assessing Remission in Cushing’s Disease. Sisli Etfal Hastan. Tip. Bul. 2023, 57, 250–256. [Google Scholar] [CrossRef] [PubMed]
- Huang, Z.; Fu, Z.; Huang, W.; Huang, K. Prognostic value of neutrophil-to-lymphocyte ratio in sepsis: A meta-analysis. Am. J. Emerg. Med. 2020, 38, 641–647. [Google Scholar] [CrossRef] [PubMed]
- Wang, R.H.; Wen, W.X.; Jiang, Z.P.; Du, Z.P.; Ma, Z.H.; Lu, A.L.; Li, H.P.; Yuan, F.; Wu, S.B.; Guo, J.W.; et al. The clinical value of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR) and systemic inflammation response index (SIRI) for predicting the occurrence and severity of pneumonia in patients with intracerebral hemorrhage. Front. Immunol. 2023, 14, 1115031. [Google Scholar]
- Bozdemir, Ş.E.; Altıntop, Y.A.; Uytun, S.; Aslaner, H.; Torun, Y.A. Diagnostic role of mean platelet volume and neutrophil to lymphocyte ratio in childhood brucellosis. Korean J. Intern. Med. 2017, 32, 1075–1081. [Google Scholar] [CrossRef] [PubMed]
- Aktar, F.; Tekin, R.; Bektaş, M.S.; Güneş, A.; Köşker, M.; Ertuğrul, S.; Yılmaz, K.; Karaman, K.; Balık, H.; Yolbaş, İ. Diagnostic role of inflammatory markers in pediatric Brucella arthritis. Ital. J. Pediatr. 2016, 42, 3. [Google Scholar] [CrossRef]
- Sen, P.; Demirdal, T.; Nemli, S.A. Predictive Value of Inflammation Markers in Brucellosis. Arch. Iran. Med. 2019, 22, 640–645. [Google Scholar] [PubMed]
- Kaya, S.; Elaldi, N.; Deveci, O.; Eskazan, A.E.; Bekcibasi, M.; Hosoglu, S. Cytopenia in adult brucellosis patients. Indian J. Med. Res. 2018, 147, 73–80. [Google Scholar] [CrossRef] [PubMed]
- Chang, C.; Beutler, B.D.; Ulanja, M.B.; Uche, C.; Zdrnja, M. Brucellosis Presenting with Febrile Pancytopenia: An Atypical Presentation of a Common Disease and Review of Brucellosis. Case Rep. Infect. Dis. 2021, 2021, 2067570. [Google Scholar] [CrossRef]
- Chen, X.; Yang, F.B.; Liang, J.Y. Brucellosis presenting with pancytopenia and hearing loss: A case report. World J. Clin. Cases 2023, 11, 5187–5192. [Google Scholar] [CrossRef]
- Sevinc, A.; Buyukberber, N.; Camci, C.; Buyukberber, S.; Karsligil, T. Thrombocytopenia in brucellosis: Case report and literature review. J. Natl. Med. Assoc. 2005, 97, 290–293. [Google Scholar] [PubMed]
- Cucuzza, M.E.; Garozzo, M.T.; Coco, M.; Di Stefano, V.A. Brucellosis: A Rare Cause of Febrile Neutropenia in a Child. Pediatr. Infect. Dis. J. 2022, 41, e430–e433. [Google Scholar] [CrossRef] [PubMed]
- Xie, S.; Zhou, Y.; Zheng, R.; Zuo, W.; Lu, X.; Wang, Y.; Zhang, Y. Brucella-induced thrombocytopenia: A retrospective study of 16 patients. J. Int. Med. Res. 2019, 47, 3008–3013. [Google Scholar] [CrossRef] [PubMed]
- Frenkel, A.; Kachko, E.; Cohen, K.; Novack, V.; Maimon, N. Estimations of a degree of steroid induced leukocytosis in patients with acute infections. Am. J. Emerg. Med. 2018, 36, 749–753. [Google Scholar] [CrossRef] [PubMed]
- Frenkel, A.; Kachko, E.; Novack, V.; Klein, M.; Brotfain, E.; Koyfman, L.; Maimon, N. The Association of Glucocorticosteroid Treatment with WBC Count in Patients with COPD Exacerbation. J. Clin. Med. 2019, 8, 1697. [Google Scholar] [CrossRef] [PubMed]
- Sharma, A.; Dai, F.; Tseng, L.; Effraim, P.R.; Zhou, B.; Schonberger, R.B.; Li, J. Systemic Effects of Perineural Glucocorticoids on Fasting Serum Glucose, Potassium, and White Blood Cell Count in Total Hip Arthroplasty. J. Pain Res. 2023, 16, 553–561. [Google Scholar] [CrossRef] [PubMed]
- Firment, J.; Hulin, I. Zahorec index or Neutrophil-to-lymphocyte ratio, valid biomarker of inflammation and immune response to infection, cancer and surgery. Bratisl. Lek. Listy 2024, 125, 75–83. [Google Scholar] [CrossRef] [PubMed]
- Topuz, B.; Sarıkaya, S.; Coguplugil, A.E.; Yılmaz, S.; Ebiloğlu, T.; Kaya, E.; Zor, M.; Gürdal, M. Our experience on Fournier’s gangrene in a tertiary-stage care center and analysis of its relationship with blood count parameters. Ulus. Travma Acil Cerrahi Derg. 2022, 28, 1285–1291. [Google Scholar] [CrossRef]
- Mangalesh, S.; Dudani, S.; Malik, A. The systemic immune-inflammation index in predicting sepsis mortality. Postgrad. Med. 2023, 135, 345–351. [Google Scholar] [CrossRef]
Modic Type 1 Changes | Modic Type 2 Changes | Modic Type 3 Changes | |
---|---|---|---|
T1 weighted MRI characteristics | Low | High | Low |
T2 weighted MRI characteristics | High | High | Low |
Histopathological characteristics | Bone marrow edema and inflammation | Fatty degeneration of the bone marrow | Subchondral bone sclerosis |
Histomorphometric characteristics | High bone turnover | Low bone formation | Stable sclerosis |
Index | Calculation |
---|---|
NLR | Neutrophil/Lymphocyte |
MLR | Monocyte/Lymphocyte |
PLR | Platelet/Lymphocyte |
NLPR | Neutrophil/(Lymphocyte * Platelet) |
SII | Neutrophil * Platelet/Lymphocyte |
SIRI | Neutrophil * Monocyte/Lymphocyte |
AISI | Neutrophil * Platelet * Monocyte/Lymphocyte |
Brucella Spondylodiscitis (n = 35) | Modic Type Changes (n = 37) | p | |
---|---|---|---|
Age, years | 46.17 ± 15.98 (18–64) | 44.46 ± 8.78 (28–62) | 0.579 * |
Gender, F/M | 17/18 | 26/11 | 0.092 ** |
Pain duration | 57.0 ± 43.51 (10–200) days | 8.73 ± 5.98 (1.0–25.0) yrs | <0.001 * |
CRP, mg/L | 40.86 ± 35.66 (3.0–136.0) | 2.65 ± 2.49 (0.17–12.24) | <0.001 * |
ESR, mm/h | 41.06 ± 21.09 (2–93) | 17.68 ± 10.57 (1.0–51.0) | <0.001 * |
Spinal levels | 0.030 *** | ||
L5–S1 | 10 (28.57%) | 22 (59.46%) | |
L4–L5 | 8 (22.86%) | 10 (27.03%) | |
L3–L4 | 5 (14.29%) | 1 (2.70%) | |
L2–L3 | 7 (20.0%) | 1 (2.70%) | |
L1–L2 | 2 (5.71%) | 1 (2.70%) | |
Two levels | 3 (8.57%) | 2 (5.41%) |
Brucella Spondylodiscitis (n = 35) | Modic Type 1 Changes (n = 37) | p | |
---|---|---|---|
Leukocyte (103/mL) | 6.52 ± 2.13 (3.40–12.80) | 7.24 ± 1.85 (3.99–12.25) | 0.127 * |
Neutrophil (103/mL) | 3.70 ± 1.78 (1.20–8.60) | 4.05 ± 1.46 (1.72–7.65) | 0.366 * |
Lymphocyte (103/mL) | 3.0 ± 0.66 (1.10–3.50) | 2.37 ± 0.68 (1.40–4.43) | 0.090 * |
Monocyte (103/mL) | 0.54 ± 0.26 (0.20–1.60) | 0.56 ± 0.24 (0.27–1.50) | 0.756 * |
Platelet (103/mL) | 263.23 ± 72.24(150–423) | 297.69 ± 72.26 (177.0–463.0) | 0.047 * |
Brucella Spondylodiscitis (n = 35) | Modic Type 1 Changes (n = 37) | p | |
---|---|---|---|
NLR | 1.95 ± 1.16 (0.67–5.55) | 1.81 ± 0.81 (0.58–5.0) | 0.553 * |
MLR | 0.27 ± 0.11 (0.08–0.55) | 0.24 ± 0.09 (0.12–0.44) | 0.294 * |
PLR | 137.77 ± 54.38 (59.09–240.0) | 134.27 ± 47.82 (54.28–297.86) | 0.772 * |
NLPR | 0.008 ± 0.005 (0.0–0.02) | 0.006 ± 0.003 (0.0–0.01) | 0.115 * |
SII | 527.12 ± 365.04 (112.0–1490.67) | 547.49 ± 305.33 (129.18–1795.0) | 0.798 * |
SIRI | 1.12 ± 1.02 (0.21–4.37) | 1.03 ± 0.65 (0.34–3.20) | 0.447 ** |
AISI | 302.87 ± 290.95 (44.80–1192.53) | 317.36 ± 239.01 (66.05–1148.80) | 0.248 ** |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Şah, V.; Baran, A.İ. Can Hematological Inflammatory Indices Be Used to Differentiate Modic Type 1 Changes from Brucella Spondylodiscitis? Medicina 2024, 60, 1131. https://doi.org/10.3390/medicina60071131
Şah V, Baran Aİ. Can Hematological Inflammatory Indices Be Used to Differentiate Modic Type 1 Changes from Brucella Spondylodiscitis? Medicina. 2024; 60(7):1131. https://doi.org/10.3390/medicina60071131
Chicago/Turabian StyleŞah, Volkan, and Ali İrfan Baran. 2024. "Can Hematological Inflammatory Indices Be Used to Differentiate Modic Type 1 Changes from Brucella Spondylodiscitis?" Medicina 60, no. 7: 1131. https://doi.org/10.3390/medicina60071131