Presentation
Back pain and fever.
Patient Data
Abnormal bone marrow signal is seen in the L3 and L4 vertebral bodies displaying T1 hypointense and STIR hyperintense signals. This is associated with irregular opposing endplates, narrowing of L3/4 disc with central T2 hyperintense focus lacking a central nuclear cleft.
Intraspinal extradural linear soft tissue component extending from the L3/L4 level disc space compressing the thecal sac against the posterior neural arch and narrowing the neural exit foramina bilaterally.
Bilateral paravertebral soft tissue components and large psoas muscle abscess also are seen.
Case Discussion
L3-4 spondylodiscitis with epidural and bilateral paraspinal and psoas muscle abscess.