Devoted to diagnostic and interventional spine imaging and therapeutics

Library

Spondylodiscits And Its Mimics 2014

Category General Spine Santanu Chakraborty, MRCP, DMRD, FRCR Satya Patro, MD Prasad Hanagandi, MD Thanh Nguyen, MD Purpose Spondylodiscitis is an infection involving the intervertebral disc and adjacent vertebrae. It has a bimodal age distribution; paediatric and late middle age / older patients. It is thought to have different pathophysiology with infection often starting in the disc itself in the paediatric age group (direct blood supply still present) whereas in adults infection begins at the end-plate, and extending into the disc space and then into the adjacent end-plate. The appearance could also be variable due to different causative organisms and host immune response. Postsurgical infection should be treated in its own separate category. There are also non-infective mimics of such appearance including Charcot's joint, Modic type I changes, acute Schmorl's node. Materials & Methods We will retrospectively review our case series for typical presentations of spondylodiscitis in multiple modalities including radiographs, CT, MRI and nuclear medicine studies. Postsurgical infection cases will be shown. Multiple mimics of a disc centered process will be illustrated with tips on differentiating these cases. A literature review regarding these will be performed to help better decision making workflow. Results Multimodlaity imaging from our case series will show typical and atypical presentation of spondylodiscitis and raise awareness of common mimics in clinical practice. Conclusion Spondylodiscitis is common and life threatening disease that needs prompt diagnosis and usually have a long treatment period. Along with clinical history and lab findings, awareness about common mimics will definitely help proper management of these patients. References MR imaging findings in spinal infections: rules or myths? Ledermann HP, Schweitzer ME, Morrison WB, Carrino JA. Radiology. 2003 Aug;228(2):506-14. Epub 2003 Jun 11.