Learning objectives
Learning the main imaging findings of spondylodiscitis,
its most frequent complications and outcomes on Computed Tomography and Magnetic Resonance Imaging.
Background
Spondylodiscitis - an inflammatory disease of the spine that affects the intervertebral disc and the adjacent vertebral body.
It is clinically manifested by fever and back pain.
Discitis exhibits a bimodal age distribution,
with peaks in early childhood and after age of 50. Male predominance can be observed.
Risk factors for discitis include diabetes,
old age,
immunosuppression,
drug use,
alcoholism,
and renal failure.
Etiology
The most common causes of spondylodiscitis:
Hematogenous penetration of infection to intervertebral disc from other sources of infection (urogenital system,
respiratory...
Findings and procedure details
The main imaging findings of spondylodiscitis on CT:
On the early stages:
-reduction of the intervertebral disc height;
- decrease in the density of the intervertebral disc.
After 1-3 weeks:
-thickening of the paravertebral soft tissues,
which can lead to compression of the nerve roots at the neural foramen;
-destruction of adjacent end plates;
-deossification of bone with loss of normal architectures of the trabecular bone
Also may be seen:
-soft tissue replacement of the bone
After treatment:
-osteosclerosis;
-the formation of a bone block...
Conclusion
CT and MRI images can provide establishing of the correct diagnose of spondylodiscitis,
disclosure of an infectious agent and indentifying of the disease complications .
Diagnostic images can allow differential diagnosis to distinguish between acute and chronic forms.
References
Mathias Prokop,
Michael Galanski. Spiral and Multislice Computed Tomography of the Body.
Lukyanenko P.
I.,
Leshchev A.
S.,
A.
A.
Strelis.
MRI in the diagnosis of tuberculous spondylitis: Guide for physicians.
- Tomsk:publishing house Veter,
2008.-P112
Charles,RW,
Govender,S,
Naidoo,
KS (1988) "Echinococcal infection of the spine with neural involvement" Spine13:47-9
L Homagk, N Homagk, HJ Meisel, GO Hofmann, and D Marmelstein.
A Spondylodiscitis Scoring System: SponDT -Spondylodiscitis Diagnosis and Treatment.
JSM Spine 1(1): 1004 (2016)