CTICasesDiscitis Osteomyelitis from Perforated IVC Filter
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Imaging findings
Lumbar spine MRI revealed indistinct endplates at the L3-L4 level with subtle marrow edema (accentuated on fat-saturated sequences), disc space destruction, and a small phlegmon along the vertebral body. An IVC filter, placed years prior, showed one prong perforating into the duodenum and another into the L3-L4 disc space, abutting the endplate. Earlier imaging showed less extension of the prongs. Biopsy fluid was cloudy with white cells, suggesting infection.
Key takeaways
Discitis osteomyelitis should be considered for focal back pain and characteristic MRI findings (endplate irregularity, marrow edema, disc destruction, phlegmon). Perforated IVC filter prongs can be a rare but severe cause of discitis osteomyelitis, particularly if they penetrate adjacent structures like the bowel or vertebral endplates, facilitating infection via direct spread or bacteremia. This highlights an unusual complication of IVC filters.
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