Discitis osteomyelitis

Case contributed by A.Prof Frank Gaillard

Presentation

Back pain

Patient Data

Age: 35
Gender: Male
Modality: CT

There is abnormality centred on T12/L1 with loss of intravertebral disc space height and bony destruction and associated sclerotic change of the L1 superior endplate and the inferior T12 vertebral endplate, which extends to the T12 superior endplate laterally on the right. L1 anterosuperior endplate fracture. Soft tissue extends posteriorly from T12/L1 intervertebral space into the central canal, resulting in moderate canal stenosis. (The conus appears to terminate above this on the MRI).

Vertebral body and intervertebral disc space height at other levels has been maintained.

Disc-osteophyte complex at L4/5 results in moderate central canal narrowing and left more than right foraminal stenosis. Central canal and intervertebral foramen are capacious at all other levels.

 

Modality: MRI

At T12/L1 there is destruction of the endplates with fluid in the disc space and extensive surrounding enhancement, narrowing the canal just below the tip of the conus. 

Case Discussion

The patient was an IV drug user and went on to have positive blood cultures for Staph. 

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Case Information

rID: 29130
Case created: 5th May 2014
Last edited: 28th Oct 2015
Tag: spine
Inclusion in quiz mode: Included

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