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Spinal disease in neurologically symptomatic HIV-positive patients
K H Taber1, L A Hayman, W X Shandera
1Department of Radiology, Baylor College of Medicine, Houston, TX 77030-3498, USA. taber@bcm.tmc.edu
Abstract:
We review the MRI findings of human immunodeficiency virus (HIV)-positive patients with "spinal" symptoms and review the literature. In 23 consecutive HIV-positive patients presenting with acute neurologic complaints thought to be referable to the spine, we reviewed spinal MRI, medical charts, and laboratory, pathologic, and autopsy data. In the early stages of HIV infection, the common causes of spinal complaints (i. e., degenerative spine and disc disease) predominated. However, pathology may be missed without contrast-enhanced MRI of the spine. In more advanced cases, the differential diagnosis includes one or more neoplastic and/or infectious causes which require contrast-enhanced MRI for detection. In these cases, normal cerebrospinal fluid findings should not preclude contrast-enhanced MRI of the spine. Imaging of the brain may also be indicated in cases when the spinal study is negative.
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