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6/27 - Study: Magnetic Resonance Imaging Screening to Identify Spinal and Paraspinal Infections Associated with Injections of Contaminated Methylprednisolone Acetate

Posted By Administration, Thursday, June 27, 2013

The objective of the study was to determine, using contrast-enhanced magnetic resonance imaging (MRI) screening, if patients who had not presented for medical care, but who had received contaminated methylprednisolone, developed spinal or paraspinal infection at the injection site. Among patients who underwent screening MRI to look for infection at the site of injection of contaminated methylprednisolone, 21% had an abnormal MRI, and all but one met CDC criteria for probable or confirmed fungal spinal or paraspinal infection. Screening MRI led to identification of patients who had minimal or no symptoms of spinal or paraspinal infection and allowed early initiation of medical and surgical treatment. Study findings support obtaining contrast-enhanced MRI of the injection site in patients with persistent back pain even when their pain disorder has not worsened. Such patients have been found to have abscesses, phlegmons, and spinal osteomyelitis or discitis with MRI. A proactive outreach to patients receiving injections from a highly contaminated lot, especially lot No. 06292012@26, is needed. Magnetic resonance imaging may detect infection earlier in some patients, leading to more efficacious medical and surgical treatment and improved outcomes. Link to full text article in JAMA:

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