Thursday, November 1, 2012

Spineless

A 60 year old man presents with 6 weeks of back pain. It has been progressively worsening and is worse at night. On examination, there is local tenderness to gentle spinal percussion and decreased range of motion of the back. Neurologic examination of the lower limbs is normal. WBC is normal. ESR and CRP are markedly elevated. Radiographs are shown above.

Challenge: What's your diagnosis?

Image shown under Fair Use.

2 comments:

Jyrvindrial said...

Spondylitis?

Craig Chen said...

Spineless

This is vertebral osteomyelitis or discitis; the radiographs demonstrate destruction of the endplates with endplate sclerosis.

Sources: UpToDate; LearningRadiology.