Acute Nontraumatic Back Pain: Infections and Mimics.
Radiographics. 2019 Jan-Feb;39(1):287-288. doi: 10.1148/rg.2019180077.
Laur O1, Mandell JC1, Titelbaum DS1, Cho C1, Smith SE1, Khurana B1.
Acute nontraumatic back pain has a broad differential diagnosis, but the primary concern in the emergent setting is the accurate and timely identification of spinal infection. Prompt diagnosis facilitates optimal medical and/or surgical management and can reduce the risk of long-term musculoskeletal and neurologic complications. MRI is the mainstay imaging modality for assessing a suspected infection. Diagnosing infection can be challenging owing to subtle imaging findings and because several noninfectious entities can mimic infection.
This online presentation reviews the anatomy, pathophysiology, and characteristic appearances of spinal infections and noninfectious mimics involving the vertebral column, facet joints, and epidural space (Fig 1). Helpful imaging clues and the use of diffusion-weighted imaging (DWI) are described to help establish the correct diagnosis. Several cases are presented in a quiz-based format to allow the reader to determine if the presented case demonstrates an infection or a mimic.