Discitis

Case contributed by Dr Jeremy Jones

Presentation

Generalised abdominal and flank pain for several weeks. Normal ultrasound. Rule out renal stone.

Patient Data

Age: 12 years
Gender: Male
Modality: X-ray

There is narrowing and irregularity of the L2/3 disc space.  Otherwise normal study.

Modality: CT

There is very subtle hypoattenuation in the superior endplate of L3, but no significant loss of height.  Incidental calyceal dilatation in the upper pole of the left kidney (filled with contrast during the excretory phase of the study).

Modality: MRI

Pathology here is centered on the L2/L3 disc space.  There disc is dehydrated and there is loss of disc-space height.  The adjacent superior endplate of L3 is abnormal with high-T2 signal and contrast enhancement.

Features here are of discitis.

Case Discussion

This case demonstrates the subtle findings of discitis on a plain film and the importance of thinking laterally when reporting paediatric imaging.  Paediatric patients often present with symptoms that are atypical.

The features of discitis on MRI here are typical with disc height loss, high T2 signal and contrast enhancement.  There is no accompanying paravertebral mass.

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Case Information

rID: 23514
Case created: 20th Jun 2013
Last edited: 31st Mar 2017
Inclusion in quiz mode: Included

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