[Magnetic resonance in the study of spondylodiscitis]

Spondylodiscitis is an uncommon pathologic condition whose diagnosis can be difficult due to its aspecific clinical and radiological signs, especially in its early phase. Seventeen patients were examined in order to evaluate MR diagnostic capabilities. They had cervical (2 cases), thoracic (3 cases) and lumbosacral (12 cases) spondylodiscitis. All patients previously underwent conventional X-ray examination and CT; bone scintigraphy was performed in 9 cases. The final diagnosis was reached by needle aspiration (10 cases), by blood culture (2 cases), or according to clinical evolution (5 cases). MR was highly sensitive in identifying the disease, also in its early stages. Moreover, MR allowed the definition of phlogistic process extent and its relationship with intersomatic disk: signal alterations were limited to the vertebral bodies and to the disk in 3 cases; endocanalar spread of phlogistic process was observed in 8 cases; extravertebral soft tissues were involved in 1 patient; involvement of both canal and paravertebral soft tissue was found in 5 patients. Signal alterations in vertebral bodies and disks, together with the good topographic evaluation obtained with MR imaging, allowed a reliable diagnosis of spondyloscitis to be reached.