Discitis-osteomyelitis (Eikenella corrodens)

Increased sclerosis within the inferior aspect of the L2 vertebral body with cortical destruction of the right anteroinferior endplate. Small volume hyperattenuation posteriorly to the L2 vertebral body which appears subligamentous resulting in indentation of the anterior thecal sac. No high- grade central canal stenosis. Paraspinous soft tissue thickening with associated retroperitoneal fat stranding. 

There is diffuse marrow signal abnormality involving the L2 vertebral body with T1 hypointensity, increased fluid signal and vertebral body enhancement. Signal abnormality extends beyond the anteroinferior corner of the endplate with linear T2 hyperintensity within the superior aspect of the L2/3 intervertebral disc and involves the anterosuperior corner of the vertebra below. There is prominent pre-vertebral enhancing soft tissue stranding extending into the medial psoas muscles bilaterally. The posterior cortex of the vertebral body is intact and there is no abnormal enhancing soft tissue within the anterior epidural space. There is subtle T2 hyperintensity and enhancement within the left L2 and to a greater extent the left L3 pedicles. 

Conclusion: Features are almost certainly those of infection. The apparent subligamentous spread with sparing of the disc raises the possibility of tuberculosis.