An unusual cause of low back pain : Osteomyelitis of the spinous process

A case report of osteomyelitis of the spinous process. To describe the diagnosis and successful treatment of a patient with spinous process osteomyelitis. Spinous process osteomyelitis is exceedingly rare and may be misdiagnosed as paraspinal muscle strain, discitis, or vertebral body osteomyelitis....

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 1998-04, Vol.23 (7), p.839-841
Main Authors: BUONCRISTIANI, A. M, MCCULLEN, G, SHIN, A. Y, BATHGATE, B, AKBARNIA, B. A
Format: Article
Language:English
Subjects:
Bacterial arthritis and osteitis
Bacterial diseases
Biological and medical sciences
Child
Female
Human bacterial diseases
Humans
Infectious diseases
Low Back Pain - etiology
Lumbar Vertebrae - diagnostic imaging
Lumbar Vertebrae - pathology
Magnetic Resonance Imaging
Medical sciences
Middle Aged
Osteomyelitis - complications
Osteomyelitis - diagnostic imaging
Radionuclide Imaging
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Summary:A case report of osteomyelitis of the spinous process. To describe the diagnosis and successful treatment of a patient with spinous process osteomyelitis. Spinous process osteomyelitis is exceedingly rare and may be misdiagnosed as paraspinal muscle strain, discitis, or vertebral body osteomyelitis. The clinical presentation of spinous process osteomyelitis is subtle, laboratory findings are nonspecific, and radiographs are often normal. The diagnosis, treatment, and outcome of two patients with spinous process osteomyelitis (an adult and a child) with insidious, nonspecific lumbar pain and fever are reviewed. Magnetic resonance imaging with and without gadolinium enhancement demonstrated increased signal of the spinous process with paraspinous musculature enhancement, a finding consistent with spinous process osteomyelitis. Biopsy results demonstrated the presence of staphylococcus aureus in the child and no organisms in the adult. Treatment with intravenous antibiotics led to resolution in both cases. The use of magnetic resonance imaging technology permitted the early and accurate diagnosis of spinous process osteomyelitis.
ISSN:0362-2436
1528-1159
DOI:10.1097/00007632-199804010-00022