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Pyogenic Osteomyelitis
Lubdha M. Shah, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Pyogenic spondylodiscitis
              • Definitions

                • Bacterial suppurative infection of vertebrae and intervertebral disc

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Kehrer M et al: Increasing incidence of pyogenic spondylodiscitis: A 14-year population-based study. J Infect. 68(4):313-20, 2014
                                              2. Shiban E et al: Spondylodiscitis by drug-multiresistant bacteria: a single center experience of 25 cases. Spine J. Epub ahead of print, 2014
                                              3. Shimizu H et al: Vertebral osteomyelitis caused by non-tuberculous mycobacteria: case reports and review. J Infect Chemother. 19(5):972-7, 2013
                                              4. Fantoni M et al: Epidemiological and clinical features of pyogenic spondylodiscitis. Eur Rev Med Pharmacol Sci. 16 Suppl 2:2-7, 2012
                                              5. Metz LN et al: Infectious, inflammatory, and metabolic diseases affecting the athlete's spine. Clin Sports Med. 31(3):535-67, 2012
                                              6. de Lucas EM et al: CT-guided fine-needle aspiration in vertebral osteomyelitis: true usefulness of a common practice. Clin Rheumatol. 28(3):315-20, 2009
                                              7. Mylona E et al: Pyogenic vertebral osteomyelitis: a systematic review of clinical characteristics. Semin Arthritis Rheum. 39(1):10-7, 2009
                                              8. Toussirot E et al: Spinal cord compression complicating aseptic spondylodiscitis in ankylosing spondylitis. Clin Exp Rheumatol. 27(4):654-7, 2009
                                              9. Dai LY et al: Anterior instrumentation for the treatment of pyogenic vertebral osteomyelitis of thoracic and lumbar spine. Eur Spine J. 17(8):1027-34, 2008
                                              10. O'Daly BJ et al: Long-term functional outcome in pyogenic spinal infection. Spine (Phila Pa 1976). 33(8):E246-53, 2008
                                              11. Kowalski TJ et al: Follow-up MR imaging in patients with pyogenic spine infections: lack of correlation with clinical features. AJNR Am J Neuroradiol. 28(4):693-9, 2007
                                              12. Solis Garcia del Pozo J et al: Vertebral osteomyelitis: long-term disability assessment and prognostic factors. J Infect. 54(2):129-34, 2007
                                              13. Ledermann HP et al: MR imaging findings in spinal infections: rules or myths? Radiology. 228(2):506-14, 2003
                                              14. Love C et al: Diagnosing spinal osteomyelitis: a comparison of bone and Ga-67 scintigraphy and magnetic resonance imaging. Clin Nucl Med. 25(12):963-77, 2000
                                              15. Wagner SC et al: Can imaging findings help differentiate spinal neuropathic arthropathy from disk space infection? Initial experience. Radiology. 214(3):693-9, 2000
                                              16. Carragee EJ: The clinical use of magnetic resonance imaging in pyogenic vertebral osteomyelitis. Spine. 22(7):780-5, 1997
                                              17. Dagirmanjian A et al: MR imaging of vertebral osteomyelitis revisited. AJR Am J Roentgenol. 167(6):1539-43, 1996
                                              18. Thrush A et al: MR imaging of infectious spondylitis. AJNR Am J Neuroradiol. 11(6):1171-80, 1990
                                              19. Modic MT et al: Vertebral osteomyelitis: assessment using MR. Radiology. 157(1):157-66, 1985
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Pyogenic spondylodiscitis
                                                          • Definitions

                                                            • Bacterial suppurative infection of vertebrae and intervertebral disc

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Nuclear Medicine Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Kehrer M et al: Increasing incidence of pyogenic spondylodiscitis: A 14-year population-based study. J Infect. 68(4):313-20, 2014
                                                                                          2. Shiban E et al: Spondylodiscitis by drug-multiresistant bacteria: a single center experience of 25 cases. Spine J. Epub ahead of print, 2014
                                                                                          3. Shimizu H et al: Vertebral osteomyelitis caused by non-tuberculous mycobacteria: case reports and review. J Infect Chemother. 19(5):972-7, 2013
                                                                                          4. Fantoni M et al: Epidemiological and clinical features of pyogenic spondylodiscitis. Eur Rev Med Pharmacol Sci. 16 Suppl 2:2-7, 2012
                                                                                          5. Metz LN et al: Infectious, inflammatory, and metabolic diseases affecting the athlete's spine. Clin Sports Med. 31(3):535-67, 2012
                                                                                          6. de Lucas EM et al: CT-guided fine-needle aspiration in vertebral osteomyelitis: true usefulness of a common practice. Clin Rheumatol. 28(3):315-20, 2009
                                                                                          7. Mylona E et al: Pyogenic vertebral osteomyelitis: a systematic review of clinical characteristics. Semin Arthritis Rheum. 39(1):10-7, 2009
                                                                                          8. Toussirot E et al: Spinal cord compression complicating aseptic spondylodiscitis in ankylosing spondylitis. Clin Exp Rheumatol. 27(4):654-7, 2009
                                                                                          9. Dai LY et al: Anterior instrumentation for the treatment of pyogenic vertebral osteomyelitis of thoracic and lumbar spine. Eur Spine J. 17(8):1027-34, 2008
                                                                                          10. O'Daly BJ et al: Long-term functional outcome in pyogenic spinal infection. Spine (Phila Pa 1976). 33(8):E246-53, 2008
                                                                                          11. Kowalski TJ et al: Follow-up MR imaging in patients with pyogenic spine infections: lack of correlation with clinical features. AJNR Am J Neuroradiol. 28(4):693-9, 2007
                                                                                          12. Solis Garcia del Pozo J et al: Vertebral osteomyelitis: long-term disability assessment and prognostic factors. J Infect. 54(2):129-34, 2007
                                                                                          13. Ledermann HP et al: MR imaging findings in spinal infections: rules or myths? Radiology. 228(2):506-14, 2003
                                                                                          14. Love C et al: Diagnosing spinal osteomyelitis: a comparison of bone and Ga-67 scintigraphy and magnetic resonance imaging. Clin Nucl Med. 25(12):963-77, 2000
                                                                                          15. Wagner SC et al: Can imaging findings help differentiate spinal neuropathic arthropathy from disk space infection? Initial experience. Radiology. 214(3):693-9, 2000
                                                                                          16. Carragee EJ: The clinical use of magnetic resonance imaging in pyogenic vertebral osteomyelitis. Spine. 22(7):780-5, 1997
                                                                                          17. Dagirmanjian A et al: MR imaging of vertebral osteomyelitis revisited. AJR Am J Roentgenol. 167(6):1539-43, 1996
                                                                                          18. Thrush A et al: MR imaging of infectious spondylitis. AJNR Am J Neuroradiol. 11(6):1171-80, 1990
                                                                                          19. Modic MT et al: Vertebral osteomyelitis: assessment using MR. Radiology. 157(1):157-66, 1985