Vertebral discitis/osteomyelitis with epidural abscess

Lateral radiograph of the cervical spine (A, C = magnification) demonstrates a scalloped area of erosive changes at the inferior endplate of C6 with loss of disc space height at C6-C7. Sagittal T2 weighted MRI of the cervical spine (B, D = magnification) shows marked bone marrow edema signal change within the C6 and C7 vertebral bodies (asterisks) along with increased fluid signal in the disc space (D, white arrow). This is compatible with discitis/osteomyelitis. An abnormal dorsal epidural fluid collection (D, black arrow) extends from C5 through T4 (here only visualized till T2 level) with narrowing of the spinal canal and compatible with an epidural abscess. There is associated increased T2 signal in the spinal cord (myelomalacia) at C6-7 as sign of significant cord compression.



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Diagnosis Vertebral discitis/osteomyelitis with epidural abscess

Lateral radiograph of the cervical spine (A, C = magnification) demonstrates a scalloped area of erosive changes at the inferior endplate of C6 with loss of disc space height at C6-C7. Sagittal T2 weighted MRI of the cervical spine (B, D = magnification) shows marked bone marrow edema signal change within the C6 and C7 vertebral bodies (asterisks) along with increased fluid signal in the disc space (D, white arrow). This is compatible with discitis/osteomyelitis. An abnormal dorsal epidural fluid collection (D, black arrow) extends from C5 through T4 (here only visualized till T2 level) with narrowing of the spinal canal and compatible with an epidural abscess. There is associated increased T2 signal in the spinal cord (myelomalacia) at C6-7 as sign of significant cord compression.

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