Presentation
One month history of severe low back pain.
Patient Data
The MRI sequences demonstrate a moderate narrowing of L4-L5 disc space with a low signal T1, high signal on T2/STIR of the L4, and L5 vertebral bodies with enhancement on postcontrast sequences indicating bone marrow edema. There is an intradiscal abscess extending to the neighboring endplates with thickening and enhancement of the pre/paravertebral and anterior epidural spaces containing small abscess formations. A mass effect is noted on the thecal sac which is displaced posteriorly.
Case Discussion
MRI features consistent with an L4-L5 spondylodiscitis with small abscess formations.
MRI is considered as the modality of choice due to its very high sensitivity and specificity. It is also helpful to differentiate between pyogenic, tuberculous, and fungal origin, and to rule out a neoplastic process.
Additional contributor; A. Ramdani, MD
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