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Related Experiment Videos

Acute MRI changes in infectious discitis: report on two cases

O S Schindler1, J Wilson-MacDonald

  • 1Royal National Orthopaedic Hospital, London, UK.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|January 1, 1995
PubMed
Summary

Early MRI may not reliably detect discitis within 48 hours of symptom onset. Absence of typical MRI findings does not exclude disc space infection, questioning the reliability of early imaging for diagnosing discitis.

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Area of Science:

  • Radiology
  • Infectious Diseases
  • Orthopedic Surgery

Background:

  • Discitis, an infection of the intervertebral disc space, is a serious condition requiring prompt diagnosis and treatment.
  • Magnetic Resonance Imaging (MRI) is the preferred imaging modality for diagnosing discitis.
  • Previous literature suggests characteristic MRI findings should appear within 48 hours of symptom onset.

Observation:

  • This report details two cases of confirmed L5/S1 discitis.
  • In both cases, MRI scans performed within 60 hours of symptom onset failed to show definitive signs of infection.
  • Typical MRI changes indicative of discitis were absent in the early stages.

Findings:

  • The reliability of early MRI (within 48-60 hours) in confirming infective discitis is questionable.

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  • The absence of typical infective changes on early MRI scans does not rule out the presence of disc space infection.
  • Diagnostic delays may occur if relying solely on early MRI findings.

    • Implications:

    • Clinicians should consider alternative diagnostic methods or repeat imaging if discitis is suspected but not evident on early MRI.
    • Further research is needed to establish the optimal timing and interpretation of MRI for early discitis detection.
    • This highlights the importance of clinical correlation alongside imaging results in diagnosing infectious discitis.