CTICasesAcute Infectious Discitis and Epidural Abscess
▶ Watch on YouTube — age-restricted, cannot embed here
Imaging findings
Chest radiograph demonstrates extremely subtle, abnormal paraspinal and mediastinal interfaces, including a subtle left-sided paraspinal opacity and an ill-defined density above the right tracheobronchial angle. Chest CT shows bone destruction and narrowing of an thoracic intervertebral disc space with associated bilateral, soft tissue paraspinal thickening. Sagittal and axial MRI of the spine confirms acute infectious discitis and osteomyelitis, accompanied by a large posterior extradural (epidural) abscess compressing the spinal cord.
Key takeaways
Acute infectious discitis can present with highly subtle abnormalities of the paraspinal and mediastinal lines on a standard frontal chest radiograph, easily mimicking a primary mediastinal process or go unnoticed entirely. When paraspinal widening or soft tissue fullness is observed, a careful evaluation of the adjacent bone structures and disc spaces is mandatory. Prompt recognition of these findings on CT should lead to urgent MRI evaluation to rule out spinal canal involvement, such as an epidural abscess, which requires emergent surgical decompression to prevent permanent neurological deficits.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Extrapleural Chest Wall LipomaNeoplastic
- Excipient Lung Disease from Methylphenidate or OxyContin InjectionExposure
- Ritalin Lung (Talc-Induced Panlobular Emphysema)Exposure
- Primary Pulmonary HemosiderosisOther
- King Supraglottic Airway DeviceArtifact
- Ectopic Parathyroid ParagangliomaNeoplastic
- SDH-Mutation Related Multicentric ParagangliomasNeoplastic
- Primary Mediastinal Non-Seminomatous Germ Cell TumorNeoplastic
See all cases from February 13, 2015 →
Related Infection cases
- Acute Myeloid Leukemia (AML) and Invasive Pulmonary Aspergillosis
- Pneumocystis jirovecii Pneumonia (PJP) with Diffuse Alveolar Damage in a Post-Transplant Patient
- Pneumocystis jirovecii Pneumonia (PJP) with Diffuse Alveolar Damage in an Undiagnosed HIV Patient
- Cystic Pneumocystis jirovecii Pneumonia (PJP) with Bilateral Spontaneous Pneumothoraces
- Disseminated Tuberculosis (Pott's Disease and Mimicking Sarcoidosis)
- Pulmonary Pneumocystis jirovecii Pneumonia and Cerebral Lymphoproliferative Disorder in HIV