Presentation
Treated pneumonia one month ago. History of lower back pain for 15 days, referring irradiation to the left. Low fever in the last week.
Patient Data
Edema and enhancement involving the bone marrow of L1 and L2 surrounded by soft tissue enhancement at the level of L1/2 extending through the left psoas, left paravertebral muscles, and epidural space (anterior, left lateral recess, and through the left L1/2 intervertebral foramen). The disc itself shows increased signal and dubious peripheral enhancement. Diffuse degenerative changes, in particular promoting moderate canal stenosis at the level of L3/4.
Case Discussion
The features are consistent with spondylodiscitis. Remote infections are a known cause of spondylodiscitis caused by spread due bacteremia. In adults, the infection is thought to begin at the vertebral body endplate, extending into the intervertebral disc space and then into the adjacent vertebral body endplate.
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