Back pain, history of prostatitis.
MRI Lumbar spine
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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.
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.