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Abstract:

Septic arthritis of a facet joint (SAFJ) is a rare but underdiagnosed clinical entity. Because of possible serious complications, it is of the utmost importance to ascertain the diagnosis and to start intravenous antibiotic therapy as soon as possible. SAFJ must be considered in patients who present with severe back or neck pain with a nocturnal component, especially when fever or biochemical signs of inflammation do occur. To avoid misdiagnosis, the next important step is to order the appropriate imaging studies. Magnetic resonance imaging with gadolinium contrast is the most sensitive and specific imaging way to diagnose SAFJ in an early stage. The infective organism can usually be identified by blood cultures. The prognosis of septic arthritis is usually favourable if antibiotic therapy is started immediately. Surgery may be indicated in case of complications or when antibiotic therapy fails. In this article, the medical history of a 65-yearold male patient with septic arthritis of two lumbar facet joints is presented, followed by a review of the literature.