Pediatric Spinal Epidural Abscess

  • Etiology: Most caused by staphylococcus aureus usually from hematogenous dissemination with or without vertebral osteomyelitis
  • Imaging MRI:
    — DWI: Very helpful to differentiate abscess from more simple fluid collections as abscesses are often more conspicuous on DWI than conventional images and DWI can identify the extent of the abscess and assist in identifying multifocal disease
  • DDX:
  • Complications:
  • Treatment:
  • Clinical:

Radiology Cases of Spinal Epidural Abscess

MRI of epidural abscess of thoracic spine
Sagittal T1 without contrast (above left), T2 (above middle) and T1 with contrast (above right) MRI of the thoracic spine shows a long extradural mass that is compressing the spinal cord and which enhances heterogeneously. Axial T2 (below left) shows bright signal intensity in the paraspinal tissues representing myositis which on T1 with contrast (below right) enhances heterogenously. The spinal cord compression from the extradural mass is also well seen on the axial images.