Infectious Spondylitis Mimics: Mechanisms of Disease and Imaging Findings

Publication date: Available online 15 November 2018Source: Seminars in Ultrasound, CT and MRIAuthor(s): Humberto MoralesAbstractInfectious processes of the spine are on the rise; in this scenario recognition of entities imitating infection is very important. The disco-vertebral unit is regarded as one of the most important and active sites in the spine. Importantly, the vertebral bony rim and the anterior corners of the vertebral bodies have significant vascularization, they are the last regions to ossify in the developmental process and suffer mechanical forces. Early septic or aseptic discitis-osteomyelitis, properly called spondylitis, involves these anterior regions. Early degeneration is characterized by disc desiccation; however, there is preferential involvement for the corners of the vertebral bodies as well. Many entities to include degenerative changes, inflammatory spondyloarthropathies, neuropathic spine or pseudo arthrosis, among others, affect the disco-vertebral unit and can imitate infection. With some exceptions, important imaging findings for the identification of an infectious mimic include the absence of soft tissue enhancement or fluid collections in the paraspinal or epidural regions, and the involvement of multiple levels or the posterior elements. We review developmental, anatomic and pathologic concepts correlating with imaging clues. Overall, our goal is to increase awareness and to improve recognition of mimicking entities.
Source: Seminars in Ultrasound, CT and MRI - Category: Radiology Source Type: research