Fact-sheet: Infectious Diskitis - Spondylodiskitis
Updated on 09/17/2021 at 12:16 PM
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Definition
Bacterial disc infection, most often hematogenous, otherwise it can be iatrogenic (surgery, discography, nucleolysis...).
Clinical features
Febrile low back pain
Laboratory findings
Pyogenic spondylodiskitis: Staphylococcus aureus, Gram-negative organisms.
Non-pyogenic spondylodiskitis: Tuberculosis, coccidioidomycosis.
Infectious syndrome.
Blood cultures, urine culture...
Disc puncture if bacteriological workup is negative
Radiography
Disc space narrowing.
Erosions of the vertebral endplates adjacent to the disc, and osteosclerosis
MRI
Reference examination:
T1 hyposignal - T2 hypersignal of the bone marrow of the vertebral bodies adjacent to the disc.
Early on, disc height is preserved, its T2 signal is generally increased.
Then disc space narrowing, erosions of the vertebral endplates adjacent to the disc, intradiscal abscess, epidural abscess of spine, perivertebral abscess
Vascular intervention
Image-guided disc puncture
Differential diagnosis
Rheumatic spondylodiskitis (Andersson lesion)