IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Lumbar vertebral osteomyelitis (sans discitis)

Case contributed by Chris O'Donnell , 9 Jun 2015
Diagnosis certain
Changed by Chris O'Donnell, 10 Jun 2015

Updates to Study Attributes

Findings was changed:

Minimal generalized reduction in T1 signal in the L4 vertebral body with subtle increased T2 signal on STIR but a heretrogeneous enhancement pattern following IV gadolinium.  Small epidural soft tissue mass behind the body of L4 producing marked thecal compression with bilateral psoas inflammatory swelling and locules of fluid (rim enhancing-enhancing) especially on the left indicative of abscess.  NotNote endplates (L3/4 abdand L4/5) are intact and the discs show no enhancement or fluid as usually seen in discitis.  Pus was drained from the psoas muscles at surgery.

Updates to Case Attributes

Body was changed:

This is an unusual case of systemic Staphylococcus aureus infection in a diabetic.  Rather than originating in the disc or endplates (spondylodiscitis), infection is located centrally in the vertebral body as osetomyelitis and has spreadosteomyelitis, spreading bilaterally into the posaspsoas muscles and posteriorly into the epidural space.   This case highlights the sensitivity of MRI with IV Gad and the insensitivity of CT scanning for the diagnosis of spinal infection.

  • -<p>This is an unusual case of systemic Staphylococcus aureus infection in a diabetic.  Rather than originating in the disc or endplates (spondylodiscitis), infection is located centrally in the vertebral body as osetomyelitis and has spread bilaterally into the posas muscles and posteriorly into the epidural space.   This case highlights the sensitivity of MRI with IV Gad and the insensitivity of CT scanning for the diagnosis of spinal infection.</p>
  • +<p>This is an unusual case of systemic Staphylococcus aureus infection in a diabetic.  Rather than originating in the disc or endplates (spondylodiscitis), infection is located centrally in the vertebral body as osteomyelitis, spreading bilaterally into the psoas muscles and posteriorly into the epidural space.   This case highlights the sensitivity of MRI with IV Gad and the insensitivity of CT scanning for the diagnosis of spinal infection.</p>

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.