Low back ache under evaluation.
MR lumbar spine and sacroiliac joints
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- STIR hyperintense signals are seen involving the L3 and L4 vertebral bodies.
- breach of the anterior half of superior end plate of L4 with a fluid signal intensity traversing the L3-4 disc superiorly to extend to the inferior end plate of L3.
- anteriorly it extends subligamentous to the right of midline mildly displacing the IVC anteriorly.
- no involvement of psoas muscles.
- no posterior extension into epidural space.
- no other vertebral joint involvement.
- rest of the intervertebral discs and lumbar vertebrae are normal.
Imaging features are typical of spondylodiskitis. This patient is of Mediterranean origin and lab investigations revealed positivity for Brucellosis. Brucella spondylodiskitis has a predilection for lumbar spine and tends to present late in view of vague symptoms.