Learning objectives
The purpose of our educational exhibit is to:
1.
evaluate the anatomical details and vascularization of discovertebral junction.
2.
review pathophysiology of spinal infection and describe Magnetic Resonance Imaging (MRI) findings.
3.
stablish a differential diagnosis to noninfectious diseases and degenerative disease.
Background
Anatomy of the adult vertebral body vascular network
Anatomy of discovertebral junction is complex,
including components of anterior and posterior elements of the spine.The anterior elements include the intervertebral discs,
Sharpey´s fibers,
vertebral body,
vertebral endplates and anterior and posterior longitudinal ligamentous complex.The posterior elements are made up of the facet joints and pars interarticulares,
as well as the pedicles,
lamina,
transverse processes and spinous processes.
The anatomy of the adult vertebral body vascular network is important in understanding the typical pattern of infection.
The...
Findings and procedure details
Generally,
high signal intensity and loss of the intranuclear cleft on T2WI are reliable findings of spondylodiscitis,
but it is difficult to detect them in the early stage.
Some noninfectious diseases (Modic type I endplate change,
acute Schmorl node,
seronegative spondyloartropathies,
Charcot arthropathy,
tumoral and posttraumatic pathologies) may present with a similar radiological pattern.
The following is a list of typical spondylodiscitis findings and some non-infectious pathologies that mimic spinal infections studied in our center.
Case 1 (Fig 1)
A 52-year-old patient with methicilin-sensitive staphylococcus...
Conclusion
Infectious spondylitis involve the vertebral body and/or the intervertebral space.
Clinical presentation is generally vague and non-specific and MRI is considered imaging modality of choice.
Radiologists should become familiar with non-infectious pathologies that mimic these spinal infections.
Correlation of imaging features with clinical symptoms and laboratory test results should be sought.
References
1.
Sung HH,
Ja-Young C,
Joon WL,
Na Ra K,
Jung-Ah C,
Heung SK.
MR Imaging Assessment of the Spine: Infection or an imitation?.
RadioGraphics 2009; 29:599-612
2.
J.L.
Bron,
M.K.
De Vries,
M.N.
Snieders et al.
Discovertebral (Andersson) lesions of the spine in ankylosing spondylitis revisited.
Clin Rheumatol (2009).
28:883-892
3.
Lee CM,
Lee S,
Bae J.
Contiguous spinal metastasis mimicking infectious spondylodiscitis.
J Korean Soc Radiol 2015; 73:408-412
4.
Ortiz AO,
Bordia R.
Injury to the vertebral endplate-disk complex associated with osteoporotic vertebral...