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Spine Infection
Lauren M. Ladd, MD; Cheryl A. Petersilge, MD, MBA
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Infectious spondylitis, vertebral body (VB) osteomyelitis, discitis-osteomyelitis, spondylodiscitis
            • Definitions

              • VB osteomyelitis: infection beginning at endplate that spreads to disc
                • Discitis: infection of disc space, spread from adjacent VB infection
              • Septic arthritis (facets): infection of synovial joints of articular facets
              • Epidural abscess: abscess in epidural space; may be isolated or related to osteomyelitis/discitis

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        • Image-Guided Biopsy

                          • Pathogen-Specific Comments

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        Selected References

                                        1. Hecquet S et al: Interest of follow-up radiological imaging in patients with pyogenic vertebral osteomyelitis. J Clin Med. 10(12), 2021
                                        2. Nguyen ML et al: Clinicoradiographic predictors of percutaneous bone biopsy results among patients with suspected thoracolumbar spine infection. Skeletal Radiol. 50(9):1801-8, 2021
                                        3. Seong I et al: Clinical and radiological features predicting intervertebral autofusion after successful antibiotic therapy in pyogenic vertebral osteomyelitis. Diagnostics (Basel). 11(8), 2021
                                        4. Fragío Gil JJ et al: Vertebral osteomyelitis: clinical, microbiological and radiological characteristics of 116 patients. Med Clin (Barc). 155(8):335-9, 2020
                                        5. Gupta A et al: Long-term outcome of pyogenic vertebral osteomyelitis: a cohort study of 260 patients. Open Forum Infect Dis. 1(3):ofu107, 2014
                                        6. Mirochnik BD et al: Case 209: disseminated coccidioidal spondylodiskitis. Radiology. 272(3):914-8, 2014
                                        7. 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
                                        8. Smida M et al: Septic arthritis of a lumbar facet joint case report and review of the literature. Acta Orthop Belg. 70(3):290-4, 2004
                                        9. Ergan M et al: Septic arthritis of lumbar facet joints. A review of six cases. Rev Rhum Engl Ed. 64(6):386-95, 1997
                                        10. Dagirmanjian A et al: MR imaging of vertebral osteomyelitis revisited. AJR Am J Roentgenol. 167(6):1539-43, 1996
                                        11. Halpin DS et al: Septic arthritis of a lumbar facet joint. J Bone Joint Surg Br. 69(3):457-9, 1987
                                        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

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Infectious spondylitis, vertebral body (VB) osteomyelitis, discitis-osteomyelitis, spondylodiscitis
                                                  • Definitions

                                                    • VB osteomyelitis: infection beginning at endplate that spreads to disc
                                                      • Discitis: infection of disc space, spread from adjacent VB infection
                                                    • Septic arthritis (facets): infection of synovial joints of articular facets
                                                    • Epidural abscess: abscess in epidural space; may be isolated or related to osteomyelitis/discitis

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Nuclear Medicine Findings

                                                            • Imaging Recommendations

                                                              • Image-Guided Biopsy

                                                                • Pathogen-Specific Comments

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              Selected References

                                                                              1. Hecquet S et al: Interest of follow-up radiological imaging in patients with pyogenic vertebral osteomyelitis. J Clin Med. 10(12), 2021
                                                                              2. Nguyen ML et al: Clinicoradiographic predictors of percutaneous bone biopsy results among patients with suspected thoracolumbar spine infection. Skeletal Radiol. 50(9):1801-8, 2021
                                                                              3. Seong I et al: Clinical and radiological features predicting intervertebral autofusion after successful antibiotic therapy in pyogenic vertebral osteomyelitis. Diagnostics (Basel). 11(8), 2021
                                                                              4. Fragío Gil JJ et al: Vertebral osteomyelitis: clinical, microbiological and radiological characteristics of 116 patients. Med Clin (Barc). 155(8):335-9, 2020
                                                                              5. Gupta A et al: Long-term outcome of pyogenic vertebral osteomyelitis: a cohort study of 260 patients. Open Forum Infect Dis. 1(3):ofu107, 2014
                                                                              6. Mirochnik BD et al: Case 209: disseminated coccidioidal spondylodiskitis. Radiology. 272(3):914-8, 2014
                                                                              7. 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
                                                                              8. Smida M et al: Septic arthritis of a lumbar facet joint case report and review of the literature. Acta Orthop Belg. 70(3):290-4, 2004
                                                                              9. Ergan M et al: Septic arthritis of lumbar facet joints. A review of six cases. Rev Rhum Engl Ed. 64(6):386-95, 1997
                                                                              10. Dagirmanjian A et al: MR imaging of vertebral osteomyelitis revisited. AJR Am J Roentgenol. 167(6):1539-43, 1996
                                                                              11. Halpin DS et al: Septic arthritis of a lumbar facet joint. J Bone Joint Surg Br. 69(3):457-9, 1987