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THU0261 Contribution of Imaging in Infectious Spondylodiscitis (About 78 Cases)
  1. Z. Alaya1,
  2. N. El Amri1,
  3. K. Baccouche1,
  4. H. Zaghouani2,
  5. S. Belghali1,
  6. D. Amri1,
  7. H. Zeglaoui1,
  8. E. Bouajina1
  1. 1Rheumatology department
  2. 2Radiology department, Hospital Farhat Hached, SOUSSE, Tunisia

Abstract

Background Infectious spondylodiscitis is an infection of the intervertebral disc and the adjacent vertebral bodies. Imaging has a key role in the diagnosis orientation, lesions assessment and bacteriological investigation.

Objectives The objective of this study was to provide an overview of the radiological features of infectious spondylodiscitis.

Methods This is a retrospective study of 78 cases of infectious spondylodiscitis collected in the Department of Rheumatology over a period of 16 years [1998-2014]. The diagnosis was made based on clinical, biological, radiological and bacteriological arguments.

Results Seventy eight patients were included. Our population consists of 50 men (64.1%) and 28 women (35.9%) with a mean age of 59.2 years [18-84 years]. Inflammatory low back pain, fever and deterioration of the general status were the most common symptoms. Neurological impairment was objectified in 55.9% of cases. Inflammatory biological syndrome was present in 89.7% of cases. Spondylodiscites was suspected according to X-ray findings in 59 cases, showing disc space narrowing and irregularity of the end-plates. MRI and spinal CT performed respectively in 76.9% of cases and 47.4% of cases showed an epiduritis in 52.6%, paravertebral abscess formation in 34.6%, and an epidural abscess in 14.2% of cases. CT- guided disco vertebral biopsy was performed in 56% of cases leading to the diagnosis in 27% of cases. The lumbar region was the most common affected (66.6%) followed by dorsal spine (26.9%) and cervical spine (8.5%). Spondylodiscitis was multifocal in 7.7% of cases and multistage in 11.5% of cases. MRI showed spinal cord compression in 15.4% of cases which was symptomatic in 9% of cases. Germs responsible of spondylodiscitis were tuberculosis in 44.9%, brucellosis in 20.5% of cases and pyogenic bacteria in 29.5% of cases. All patients underwent adapted antibiotics.

Conclusions Imaging has an important role in the diagnosis of infectious spondylodiscitis. MRI is considered as the imaging technique of choice in infectious spondylodiscitis which can provide a mapping of the lesions and detects potentially serious neurological complications. The importance of whole spine imaging should be also underlined especially in case of multifocal infectious spondylodiscitis.

Disclosure of Interest None declared

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