Cervical spondylodiscitis

Case contributed by Dr Ian Bickle

Presentation

Middle aged diabetic with acute on chronic neck pain.

Patient Data

Age: 45 years old
Gender: Male
X-ray

Outpatient cervical radiograph - 3/12 prior.

Normal appearances - vertebral and disc spaces normal.

No bony destruction.

Normal pre-vertebral soft tissue thickness.

X-ray

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

C5-C6 disc space narrowing.

Destruction of neighbouring endplates, especially the C5 vertebral body.

Enlarged pre-vertebral soft tissue thickening.

MRI

Reduced bone marrow signal in C5 and C6.

High signal in the C5-C6 disc space.

Pre-vertebral collection from C4-C6.

CT
X-ray

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
Case created: 8th Mar 2014
Last edited: 13th Mar 2016
Inclusion in quiz mode: Included

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