Disk Space Infection

Nancy D Baker, MD

May 17, 1994

Presentation

Imaging Findings

Bone scintigraphy shows increased uptake at T12-L1 (arrow).

A lateral radiograph of the thoracolumbar spine shows obliteration of the disc space and indistinctness of the apposing vertebral endplates.

Three weeks later, an anteroposterior radiograph of the thoracolumbar spine shows complete absence of the T12-L1 disc space and widening of the paraspinal lines. A coned lateral radiograph, also taken three weeks after the bone scan, shows further disc space loss and vertebral endplate destruction. A slight anterior wedge of the vertebral bodies is now evident.

Computed tomography at T12 shows bone destruction and paraspinal soft tissue swelling. Another section at L1 shows two gas bubbles in the destroyed disc space, likely due to gas-producing microorganisms.

A lateral topogram (scanogram) obtained during CT guided needle biopsy of the T12-L1 disc space shows placement of the large bore needle to obtain a core of bone and disc fluid. The pathology findings were consistent with chronic inflammation. No organism was ultured or identified with special stains.

Diagnosis

Discussion

References

• Return to the Teaching Case Database search page
• Return to Professional Education
  
• About BrighamRAD

Dear Visitors: Nothing on this World Wide Web site should be considered medical advice. Only your own doctor can help you make decisions about your medical care. It is not the policy of the Brigham and Women's Hospital Department of Radiology to provide consultation on the World Wide Web or via e-mail. If you have a specific medical question or are seeking medical care, please call the Brigham and Women's Hospital toll-free physician referral line at 1-800-294-9999.

Is this a mirrored page?
The official homepage of the BrighamRAD Teaching Case Database is http://brighamrad.harvard.edu/education/online/tcd/tcd.html