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Spondylodiscitis and Its Mimickers: A Pictorial Review
Claudia Lucia Piccolo1, Alberta Villanacci2, Federica Di Stefano2
1Department of Radiology, Fondazione Policlinico Campus Bio-Medico, 00128 Rome, Italy.
Abstract:
Spondylodiscitis is an infection of the intervertebral disc, the adjacent vertebral body, and/or contiguous structures due to the introduction of infectious agent, usually by the hematogenous route. Imaging is crucial in assessing bacterial and tubercular spondylodiscitis, as well as their associated complications. Magnetic resonance imaging in particular can clearly depict osteo-structural changes in the vertebral body and the associated disc, as well as any soft-tissue complications, such as paravertebral abscess and/or epidural abscess, improving disease characterization and helping to recognize the agent involved. Nevertheless, other non-infectious diseases may mimic imaging appearances of spondylodiscitis and one should be aware of these conditions when interpreting MR images, which include Modic type I degenerative changes, ankylosing spondylitis, acute Schmorl's node, porotic fractures, and spinal neuropathy arthropathy. This pictorial review aims at describing imaging findings of bacterial and non-bacterial spondylodiscitis, complications, and those pathologies that mimic these infections.
Insights
Spondylodiscitis, an infection of the spine, is best assessed with imaging. Magnetic resonance imaging (MRI) helps identify infections and complications, but mimics non-infectious conditions.
Area of Science:
- Radiology
- Infectious Diseases
- Spinal Imaging
Background:
- Spondylodiscitis involves infection of the intervertebral disc and adjacent vertebrae.
- Hematogenous spread is the usual route of infection.
- Imaging is vital for diagnosis and complication assessment.
Purpose of the Study:
- To review imaging findings of bacterial and non-bacterial spondylodiscitis.
- To describe associated complications.
- To highlight conditions that mimic spondylodiscitis on imaging.
Main Methods:
- Pictorial review of imaging findings.
- Focus on Magnetic Resonance Imaging (MRI) characteristics.
- Comparison with non-infectious mimics.
Main Results:
- MRI effectively visualizes vertebral and disc changes.
- MRI detects soft-tissue complications like abscesses.
- Differential diagnosis includes degenerative changes, spondyloarthropathies, and fractures.
Conclusions:
- MRI is crucial for characterizing spondylodiscitis and its complications.
- Awareness of imaging mimics is essential for accurate diagnosis.
- Distinguishing infectious from non-infectious spinal conditions is key.
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