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Discitis/Osteomyelitis

KEY FACTS Terminology Bacterial suppurative infection of intervertebral disc & adjacent vertebrae Imaging Disc-centered process: Disc space narrowing & adjacent endplate irregularity in young children Lumbosacral (75%) > thoracic > cervical spine Early: MR imaging most sensitive, specific modality Abnormal disc signal & enhancement Ill-defined abnormal marrow signal & enhancement Paraspinal & epidural phlegmon or abscess Subacute Endplate destruction/erosion Chronic Increased bone density ± vertebral fusion…

Approach to Pediatric Spine

Imaging Modalities Ultrasound In the newborn, the spine is most commonly imaged when a cutaneous lesion overlies the lumbosacral spine & implies the presence of an underlying spinal abnormality. Common examples requiring deeper imaging investigation include a cutaneous infantile hemangioma, hairy patch, fatty mass, appendage, forked gluteal crease, or atypical dimple (& do not include the common low-lying, shallow midline dimple near the anus). Within the…