Background Infectious spondylodiscitisis represents a diagnostic and therapeutic emergency. Imaging is fundamental in the management of the disease.
Objectives The aim of this study is to analyze the contribution of imaging in the diagnosis of infectious spondylodiscitis.
Methods This is a retrospective study which included medical records of patients treated for psoas abcess during the twelve past years [2006–2016]. Epidemiologic, clinical, and imaging data (Standard X ray, Computed tomography (CT), magnetic resonance imaging (MRI)) were recorded and analysed.
Results Ninety patients were included in this study. The average age was 55 years [16–86] with an even distribution between males and females. Mean symptom duration was of 4 months. The most frequently isolated pathogen was Mycobacterium tuberculosis (63.3%), followed by pyogenic germs (21.2%) and Brucella (15.5%). Standard X ray were pathological in 89% of cases: showed narrowing of intervertebral space (72.2%), endplate destruction (42.2%), erosions of vertebra (13.3%), opacity (12.2%), vertebral fracture (10%), paravertebral spindle (5.5%) and posterior archlysis lesion (2.2%). Standard radiographswere normal in 12 cases and in 1 case, spinal CT showed vertebral destruction wirh “ mirror-image ”. Spinal MRI, performed in the remaining 11 cases, confirmed the diagnosis in all cases and showed paravertebral collections (n=3), epiduritis (n=3), psoas abscess (n=2), microabscess (n=1) and spinal compression (n=1). In case of posterior archlysis lesion and vertebral fracture, MRI confirmed the diagnosis by showing paravertebral collections.
Conclusions Management of infectious spondylodiscitis has benefited from advancements in imaging allowing an early diagnosis and treatment.
Disclosure of Interest None declared