- Etiology: infection starting in vertebral endplates and then spreading into disk space, can be due to bacteria (Staphylococcus aureus) or virus
- Radiograph: usually in lumbar spine at L2-3 / L3-4, takes 2-4 weeks for disk space narrowing and end plate erosion to occur, 6-10 weeks for flattening of vertebral body
- Bone scan with SPECT: positive earlier than plain films with increased uptake in disk spaces and vertebral bodies
- CT: helps define paravertebral soft tissue masses, epidural involvement, vertebral body involvement
- MRI: disk signal isointense on T1 and decreased on T2, marrow signal decreased on T1 and increased on T2, best to check for epidural abscess
- Clinical: usually in < 5 years old due to increased regional vascularity of vertebral endplates / intradiscal extension of end arteries
Radiology Cases of Osteomyelitis Diskitis


