Imaging clues for the diagnosis of various pathogenic causes of infectious spondylitis

Infectious spondylitis is not a common disease; however, its incidence has increased recently due to the increasing number of older patients with chronic diseases and immunocompromised status globally. The clinical presentation of infectious spondylitis may be non-specific, causing delays in diagnosis and treatment, and leading to significant sequelae. Imaging usually plays a crucial role in characterizing the presence and extent of the disease, leading to proper management, reduced mortality, and long-term neurological morbidity. Many studies have proposed imaging features to distinguish between the common causes of infectious spondylitis, pyogenic or tuberculous infections, while the less common infections, including those caused by fungi or other bacterial organisms such as brucellosis, melioidosis, and actinomycosis, are believed to lack specific imaging characteristics. In this review, we highlight the characteristic imaging findings of both common and uncommon pathogens, which can serve as key clues for accurately diagnosing various pathogenic causes of infectious spondylitis.