Overview
What is the pathophysiology of diskitis?
What is the prevalence of diskitis?
What is the prognosis of diskitis?
What should be included in patient education about diskitis?
Presentation
Which clinical history findings are characteristic of diskitis?
Which physical findings are characteristic of diskitis?
DDX
What conditions should be considered in the differential diagnoses of diskitis?
What are the differential diagnoses for Diskitis?
Workup
What is the role of lab testing in the diagnosis of diskitis?
What is the role of plain radiography in the diagnosis of diskitis?
What is the role of MRI in the diagnosis of diskitis?
What is the role of CT scanning in the diagnosis of diskitis?
What is the role of radionuclide scanning in the diagnosis of diskitis?
What is the role of echocardiography in the diagnosis of diskitis?
What is the role of needle biopsy in the diagnosis of diskitis?
What is the role of surgical biopsy in the diagnosis of diskitis?
Which histologic findings suggest diskitis?
Treatment
What is the role of antibiotics in the treatment of diskitis?
What is the role of immobilization in the treatment of diskitis?
What is the role of pain medications in the treatment of diskitis?
What are indications for the surgical treatment of diskitis?
What is the goal of surgery for diskitis?
What is the efficacy of surgery for diskitis?
What are the possible complications of diskitis?
Which dietary modifications are used in the treatment of diskitis?
Which activity modifications are used in the treatment of diskitis?
Which specialist consultations are beneficial to patients with diskitis?
What is included in the long-term monitoring of patients with diskitis?
Medications
Which medications are used in the treatment of diskitis?
Which medications in the drug class Antibiotics are used in the treatment of Diskitis?
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Axial CT scan in a patient with diskitis demonstrates extensive destruction of the vertebral endplate. Note the preservation of the posterior elements, including facet joints, lamina, and spinous process. This is characteristic for pyogenic diskitis and less common in tuberculosis (Pott disease).
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Sagittal T1-weighted MRI of the lumbar spine in a 74-year-old man, revealing diskitis of the L4-L5 disk space. Note extensive destruction of the endplates of the adjacent vertebral bodies. No compression of the thecal sac is present, which is an important consideration when contemplating surgical intervention.
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Contrast-enhanced sagittal T1-weighted MRI image in a 55-year-old woman shows thoracic diskitis with an associated epidural abscess and spinal cord compression. Because of the significant cord compression, this patient underwent surgical decompression.
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Trajectory of a needle in a biopsy of the infected disk space guided by CT scan. Care is taken to avoid the thecal sac and nerve roots.