- 722.90 Intervertebral disc disorders; unspecified region
Diskitis Etiology / Epidemiology / Natural History
- 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 Follow-up Care
Diskitis Review References
- Ring D, JPO 1995;15:652
- Crawfore AH, CORR 1991;266:70