Calcific discitis in children: vertebral body involvement (possible insight into etiology)

The aim of the study was to present our cases of calcific discitis, analyze the imaging findings, and review the literature in an attempt to formulate a possible etiology. We reviewed the imaging and clinical findings in nine patients with calcific discitis and accomplished a literature review of the condition. There were nine patients, five males and four females. Age range was 5-13 years with a mean of 9.7 years. Twenty-three discs were involved, nine cervical and fourteen thoracic. Four cervical discs were not calcified but merely swollen. One patient presented with abnormal magnetic resonance (MR) signal changes within a vertebral body. Our literature search revealed another such patient and brought up the possibility that the insult to the disc might be secondary to vertebral body involvement and disruption of the tenuous vascular/nutritional support of the intervertebral disc from the adjacent vertebral body. In the early stages of calcific discitis, only swelling and expansion of the disc are seen. More recently, with MR imaging, vertebral body involvement has been demonstrated to also occur. As a result, it may be that the initial insult (vascular compromise) is to the vertebral body (nutritional support for the disc) rather than to the disc.