Septic arthritis of a lumbar facet joiunt caused by Staphylococcus Aureus
Rombauts, Pascale × Linden, Patrick Buyse, Annemie Snoeckx, Michel Lysens, Roeland Gryspeerdt, Stefaan #
Spine vol:25 issue:13 pages:1736-1738
Study design. A case report of a 35-year-old woman with septic artritis of a lumbar facet joint.
Objectives. To report a rare case of severe low back pain and the specific differential diagnostic problems.
Summary of backgroud data. Differential diagnosis between spondylodiscitis and facet joint septic arthritis on a clinical basis is very difficult. The lesions of the joint appear on aplain film only approximately 1.5 months after onset of the symptoms. Although the radionuclide bone scan is sensitive and shows a more laterally and vertically localized uptake than in spondylodiscitis, this technique is not very specific. Computed tomography scan and magnetic resonance imaging are the most reliable investigations even at the very early stages of the disease. Confirmation of the diagnosis has to be obtained by blood cultures or, in exceptional cases, by direct punture of the joint. Appropriate antibiotic treatment is in most casses sufficient to heal this lesion.
Methods. the etiology, clinical pr"esentation, technical examinations, and treatment are reviewed.
results. Computed tomography scan and magnetic resonance imaging complemented by positive blood cultures led to the very early diagnosis of septic arthritis of the lumbar facet joint in this relatively young patient.
Conclusions.With our case report we confirm the very small number of data reported in the literature, indicating that infections of the facet joint can be detected at a very early stage using magnetic resonance imaging and computed tomgraphy scan.