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Contiguous discitis and osteomyelitis in children

K S Song1, J A Ogden, T Ganey

  • 1Keimyung University School of Medicine, Daegu, Korea.

Journal of Pediatric Orthopedics
|July 1, 1997
PubMed
Summary
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Magnetic resonance imaging (MRI) accurately diagnosed contiguous discitis and osteomyelitis in 16 patients, revealing vertebral and soft-tissue changes. Long-term follow-up showed significant disc-space narrowing and potential vertebral fusion.

Area of Science:

  • Pediatric Radiology
  • Spinal Infections
  • Musculoskeletal Imaging

Background:

  • Contiguous discitis and osteomyelitis are serious spinal infections.
  • Accurate diagnosis and assessment of extent are crucial for management.
  • Understanding the long-term sequelae is important for patient outcomes.

Purpose of the Study:

  • To evaluate the utility of magnetic resonance imaging (MRI) in diagnosing contiguous discitis and osteomyelitis.
  • To define the anatomic extent of vertebral and soft-tissue involvement.
  • To assess the long-term sequelae of these infections in pediatric patients.

Main Methods:

  • Retrospective review of 16 patients with contiguous discitis and osteomyelitis.
  • Detailed analysis of MRI findings, including signal changes in discs, vertebrae, and soft tissues.

Related Experiment Videos

  • Serial roentgenogram comparison for assessing changes in disc-space height and vertebral foramina.
  • Histologic examination of vascular anatomy in immature vertebrae.

    • Main Results:

    • MRI provided specific diagnoses and delineated the extent of infection in all patients.
    • Common MRI findings included altered signal in discs, adjacent vertebrae, and prevertebral tissues.
    • Long-term follow-up revealed significant disc-space height reduction (mean 43%), loss of lumbar lordosis, and progressive vertebral fusion in some cases.
    • Narrowing of vertebral foramina was observed in 7 patients.

    Conclusions:

    • MRI is a valuable tool for diagnosing contiguous discitis and osteomyelitis and assessing its extent.
    • These infections can lead to significant long-term spinal deformities and complications.
    • Understanding the vascular anatomy of immature vertebrae aids in explaining disease characteristics.