Spondylodiscitis

Case contributed by Dr Bruno Di Muzio

Presentation

Back pain, history of prostatitis.

Patient Data

Age: 51-year-old
Gender: Male
MRI

MRI Lumbar spine

 

At L3-4, there is destruction of endplate, fluid disc signal, irregular endplates and enhancement, worst the endplates, but also involving most of the L3 and L4 vertebral bodies. Surrounding prevertebral enhancing soft tissue from L2-3 to L4-5, with enhancement involving both right and left adjacent psoas muscles. Small amount of anterior epidural enhancement and thickening that stenoses the left foramen. Mild narrowing of the canal. No drainable collection. Mild to moderate posterior paraspinal edema.

Conclusion: Findings are in keeping with L3-4 discitis-osteomyelitis with surrounding inflammatory phlegmon that stenoses the left lateral recess.

Case Discussion

This case demonstrates typical features of spondylodiscitis in an adult patient with a recent diagnosis of prostatitis. Remote infections are a known cause of spondylodiscitis caused by spread due bacteraemia. In adults, the infection is thought to begin at the vertebral body endplate, extending into the intervertebral disc space and then into the adjacent vertebral body endplate.

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Case information

rID: 42805
Case created: 9th Feb 2016
Last edited: 14th Feb 2016
System: Spine
Tag: rmh
Inclusion in quiz mode: Included

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