IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

L3/4 osteomyelitis-discitis with epidural abscess

Case contributed by RMH Core Conditions
Diagnosis certain

Presentation

Low back pain. Lower limb weakness.

Patient Data

Age: 62
Gender: Male

Anterior T2 hyperintense extradural collection with peripheral enhancement extends from above the imaged vertebrae to the mid-sacrum, with associated mild posterior displacement of the theca.

Hyperintensity of a markedly narrowed L3/4 intervertebral disc is on sagittal T2 fat suppressed images, within destructive change within the posterosuperior aspect of the L4 endplate. Bone marrow edema signal is noted within the L3/4 vertebral bodies.

Conclusion:

Anterior thoracolumbar epidural abscess extending from thoracic-midsacrum likely relating to discitis/osteomyelitis of L3/4.

Case Discussion

Spinal epidural abscess are is a rare but serious condition. MRI is the modality of choice for imaging and has high sensitivity and specificity for detection. Treatment is typically with surgical drainage and IV antibiotics. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.