Spondylodiscitis

Discussion:

This case demonstrates the subtle findings of discitis on a plain film and the importance of thinking laterally when reporting pediatric imaging.  Pediatric patients often present with symptoms that are atypical.

The features of discitis on MRI here are typical with disc height loss, high T2 signal and contrast enhancement. There is no accompanying paravertebral mass.

The most common causative agent is Staph aureus. In tuberculous discitis, there may be a large pre- or para-vertebral collection which is out of proportion to how unwell the patient is.

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