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vertebral osteomyelitis / discitis

see also:



Clinical features

  • severe midline back pain with spinal tenderness
  • fever may present early or be a late feature but only half develop fevers before diagnosis
  • in children, it may present as refusal to walk or arching the back


Initial Ix of suspected discitis

  • FBE, U&E, CRP, ESR, 2 sets of blood cultures
    • the WCC is often normal, but the CRP and ESR are raised in over 80%
  • emergent MRI scan

Mx of proven discitis

  • early referral to neurosurgery
  • as the disc has poor vascularity, potent antibiotics may be needed such as ciprofloxacin / vancomycin
  • patients are usually best to keep mobilizing to maintain blood flow to the disc which otherwise will decline with bed rest
  • if abscess forms, it may require surgical drainage
discitis.txt · Last modified: 2018/08/08 09:15 by

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