Presentation
Eventually the pain became so severe that he presented to the emergency room two months after undergoing the LP. On presentation he had a leukocytosis (white blood count 20.7) and mildly elevated erythrocyte sedimentation rate (37). [n.neurology.org]
This comparative study suggests that age and clinical presentation distinguish most patients with discitis from those with vertebral osteomyelitis. [pediatrics.aappublications.org]
Seventeen patients presented two comorbidities and one patient had three comorbidities. [ncbi.nlm.nih.gov]
A neurologic deficit is uncommon, but when present should raise suspicion for a complicating epidural abscess. [radsource.us]
The prolonged treatment course and the considerable pain and immobility can lead to situational depression that should be treated if present. [muschealth.org]
Entire Body System
- Weight Loss
loss (when the delay in diagnosis is long) [4] Mortality 2-17% [2] in children (symptoms are non-specific) Irritability Limping Refusal to crawl, sit or walk Hip pain or even abdominal pain Incontinence may be a presenting feature Loss of lumbar lordosis [physio-pedia.com]
A T1-weighted sagittal image shows loss of disc space height at T12-L1 (arrow) with marked hypointensity of the endplates. [radsource.us]
- Fatigue
Fatigue, loss of appetite, and refusal to stand, walk or sit up may also occur. In order to diagnose discitis, the physician will review the patient's medical history and follow with a physical exam. [neurosurgicalassociatespc.com]
- Falling
A decrease in serum ESR and CRP indicates a successful response, with CRP being the more sensitive of the two; ESR levels should fall by one third to one half, but frequently never return to pre-disease levels. [radsource.us]
Gastrointestinal
- Abdominal Pain
Key Symptoms Discitis causes the following symptoms: Pain in certain parts of the spine Pain in the lower and upper back Changes in posture Back stiffness Difficulty performing regular tasks Fever Abdominal pain The pain caused by discitis can be quite [docdoc.com.sg]
Other symptoms can include: changes in your posture stiffness in your back difficulty performing regular mobility tasks abdominal pain or discomfort fever Viral or bacterial infections can cause discitis. An autoimmune disorder can also cause it. [healthline.com]
[…] or even abdominal pain Incontinence may be a presenting feature Loss of lumbar lordosis and lower back movement Compared with adults, children are less likely to have comorbidities and neurological deficits are uncommon [1] The severity of the infection [physio-pedia.com]
Musculoskeletal
- Lordosis
Clinical examination [2] (level of evidence 2A) Inspection concentrating on local changes and taking a detailed neurological status Spinal tenderness [1] Loss of lumbar lordosis and lower back movement [1] Inspection on local changes and neurological [physio-pedia.com]
- Leg Weakness
weakness, paralysis, sensory deficit, radiculopathy and sphincter loss (1/3 of the cases) [1] [10] [4] Cervical lesion [1] Spinal tenderness restricted range of movement [1] paravertebral muscle spasm [1] Local tenderness [5] Motor deficits: limb weakness [physio-pedia.com]
Urogenital
- Renal Insufficiency
Diabetes, AIDS, steroid use, cancer, and chronic renal insufficiency are common comorbidities. [1] Although rare, infection of the disk space can also occur following surgical intervention at the site. [emedicine.medscape.com]
Treatment
Most of the treatment used for discitis eliminates infection and relieves pain. [orthoneuro.com]
Patients who undergo antibiotic therapy for discitis often require a standard treatment period of 6 to 8 weeks. [docdoc.com.sg]
Treatment Treatment of discitis depends on age and cause of the infection. Elimination the cause of infection and getting rid of pain and other symptoms is the goal of treating discitis. [neurosurgicalassociatespc.com]
Treatment [ edit ] Treatment usually includes antibiotics, and reducing the mobility of the affected region, either with a back brace or a plaster cast. Without treatment, the patient may form an abscess which may need to be surgically corrected. [en.wikipedia.org]
For example, surgery on the back or a needle placed in the back for a diagnostic or treatment can introduce pathogens. [muschealth.org]
Prognosis
The prognosis for patients suffering from discitis is heavily influenced by how early the condition is diagnosed and treated. [docdoc.com.sg]
Postoperative Spondylodiskitis: Etiology, Clinical Findings, Prognosis, and Comparison with Non-Operative Pyogenic Spondylodiskitis. Clin Inf Dis, 1999; 29:339-345. [radsource.us]
Prognosis seems to be good with conservative treatment including NSAID’S, physiotherapy (exercises), and a corset. Extension:RSS -- Error: Not a valid URL: Feed goes here!! [physio-pedia.com]
Prognosis Most patients are cured by a treatment protocol of antibiotics, either alone or in combination with surgery. Only 15% of patients experience permanent neurologic deficits. Recrudescence of infection occurs in 2-8% of patients. [emedicine.medscape.com]
Etiology
Postoperative Spondylodiskitis: Etiology, Clinical Findings, Prognosis, and Comparison with Non-Operative Pyogenic Spondylodiskitis. Clin Inf Dis, 1999; 29:339-345. [radsource.us]
Etiology Diskitis is thought to spread to the involved intervertebral disk via hematogenous spread of a systemic infection (eg, urinary tract infection [UTI]). [emedicine.medscape.com]
Etiology and ecology. Arch Intern Med. 1962; 110 :847–855. doi: 10.1001/archinte.1962.03620240029006. [ CrossRef ] [ Google Scholar ] 2. McHenry MC, Easley KA, Locker GA. [ncbi.nlm.nih.gov]
The difference between the two types, is that the intervertebral disc and the joint space are preserved longer in the tuberculous spondylodiscitis. [8] Epidemiology /Etiology According to scarce researches, the incidence of spondylodiscitis is 2.4/100,000 [physio-pedia.com]
Epidemiology
The main aim of this paper is to discuss recent concepts regarding the epidemiology, microbiology, clinical presentation, diagnosis, and treatment of pediatric D and SD. [pubmed.ncbi.nlm.nih.gov]
Epidemiology In the United States, the incidence of diskitis ranges from 1 in 100,000 population to 1 in 250,000 population. [emedicine.medscape.com]
Search Strategy Keywords : Spondylodiscitis + Diagnosis / Therapy / Epidemiology / Rehabilitation / Rehabilitation / Examination / Symptoms / Characteristics / Clinical Search engines : Pubmed Web of knowledge PEDro Definition/Description Spondylodiscitis [physio-pedia.com]
Introduction and epidemiology The optimal management of pyogenic discitis is not agreed on. Little is known about the risk factors, clinical features, diagnosis, optimal treatment, or management outcomes of adults with spontaneous discitis. [ncbi.nlm.nih.gov]
Epidemiology Discitis exhibits a bimodal age distribution, with peaks in early childhood and after age 50. A male predominance is seen. [radsource.us]
Pathophysiology
Pathophysiology An infection does not ordinarily originate in the vertebra or disk space; rather, it typically spreads there from other sites via the bloodstream. [emedicine.medscape.com]
Postoperative discitis accounts for approximately 20-30% of cases of discitis.1,2 Pathophysiology Most cases of discitis are secondary to infection elsewhere in the body, with the most common source being the genitourinary tract; other less common sources [radsource.us]
Prithvi, et al., Intervertebral Disc: Anatomy-Physiology-Pathophysiology-Treatment, Department of Anesthesiology and Pain Management, World Institute of Pain, 2008 (level of evidence 2A) ↑ 10.00 10.01 10.02 10.03 10.04 10.05 10.06 10.07 10.08 10.09 10.10 [physio-pedia.com]
Prevention
This is why patients with discitis should be treated immediately to prevent serious complications. Causes of Condition Discitis cases are classified as either spontaneous or post-operative. [docdoc.com.sg]
Risks and Benefits Failure to take preventive measures for any spinal condition may result in a further aggravated condition. Surgical measures for advanced cases may give relief from extremity pain. [neurosurgicalassociatespc.com]
Activity of parts of the body not affected, like arm exercises, should be done to prevent generalized weakness. Eating a healthy diet and responsible drinking are probably important. [muschealth.org]
Preventing and treating discitis: cephazolin penetration in ovine lumbar intervertebral disc. Eur Spine J. 2006 Sep. 15 (9):1397-403. [QxMD MEDLINE Link]. [emedicine.medscape.com]
Keeping the hamstrings flexible is important for pain control as well as in prevention of spinal pain flare-ups. [physio-pedia.com]