Cervical spondylodiskitis

Case contributed by Dr Ian Bickle


Middle aged diabetic with acute on chronic neck pain.

Patient Data

Age: 45 years
Gender: Male

Outpatient cervical radiograph - 3/12 prior.

Normal appearances - vertebral and disc spaces normal.

No bony destruction.

Normal pre-vertebral soft tissue thickness.


3/12 later, films repeated for neck pain on admission to hospital.

C4-C5 disc space narrowing.

Destruction of neighboring endplates, especially the C5 vertebral body.

Enlarged pre-vertebral soft tissue thickening.


Reduced bone marrow signal in C4 and C5.

High signal in the C4-C5 disc space.

Pre-vertebral collection from C3-C5.


Vertebral body destruction at C4-C5 with associated prevertebral soft tissue swelling.


1 month later after surgical fixation.

Internal fixation from C4-C6.

The pre-vertebral soft tissue remains thickened.

Case Discussion

An 'time-lapse' case of cervical osteomyelitis from normal to post fixation films.

An associated pre-vertebral collection is evident, which is responsible for the important lesson in pre-vertebral soft tissue widening on the presentation plain film.

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Case information

rID: 28057
Published: 4th May 2014
Last edited: 26th Dec 2019
Inclusion in quiz mode: Included

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