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Discitis (Pediatric) M46.40 722.90

 

synonyms:Discitis, diskitis

Diskitis ICD-10

Diskitis ICD-9

  • 722.90 Intervertebral disc disorders; unspecified region

Diskitis Etiology / Epidemiology / Natural History

  • Generally <5y/o.

Diskitis Anatomy

  • Generally affects lumbar discs.

Diskitis Clinical Evaluation

  • Backache, limp, pain with ambulation, +/- fevers

Diskitis Xray / Diagnositc Tests

  • CBC with differential, ESR (rises within 2 days, continues to rise for 3-5 days even with treatment), CRP (rises witin 6 hours, peaks at 48 hrs, normal witin 1 week), blood cultures, gram stain, CXR. Consider Acid-fast staining, fungal cultures, prolonged incubation times (especially for infections after arthroscopic surgery).
  • Spine xrays indicated, may show disc space narrowing
  • MRI: highest sensitivity and specificity for infection / osteomyelitis. low signal intensity in bone marrow on T1 images may indicated osteomyelits (bone marrow normally has high-signal intensity on T1 images).
  • Bone scan: technetium 99m; gallium citrate Ga 67; indium-111 leukocyte-labeled etc.

Diskitis Classification / Treatment

  • IV antibiotics with S aureus and GABHS coverage for 7 days followed by 7-14 days of PO antibiotics. Associated perivertebral abcesses typically resolve without surgical intervention.

Diskitis Associated Injuries / Differential Diagnosis

Diskitis Complications

Diskitis Follow-up Care

Diskitis Review References

  • Ring D, JPO 1995;15:652
  • Crawfore AH, CORR 1991;266:70
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