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1. Vertebral osteomyelitis and psoas abscesses

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Figure 23-1

Vertebral osteomyelitis and psoas abscesses.

A. A lateral lumbar spine radiograph demonstrates destruction and collapse of the anterior-superior aspect of the L3 vertebral body. There is L2-L3 disc space narrowing. The paraspinal soft tissue is prominent. B. A contrast-enhanced CT image at the level of the vertebral defect shows large bilateral psoas abscesses.

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2. Osteomyelitis

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Figure 23-2

Osteomyelitis.

A. A sagittal STIR image of a 12-year-old child shows extensive sacral hyperintensity (arrow) due to inflammatory edema. The signal abnormality extends into the adjacent soft tissues. The S1-S2 disc serves as a barrier to spread of the infection. B. CT 2 weeks later shows permeative destruction of the sacrum (arrow), as well as reactive sclerosis.

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3. Vertebral osteomyelitis and psoas cellulitis

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Figure 23-3

Vertebral osteomyelitis and psoas cellulitis.

A. A coronal T1-weighted MR image shows hypointensity of the L3 marrow. There is a defect in the right lateral cortex (arrow). The right psoas muscle is enlarged. B. Edema results in hyperintensity in the L3 marrow and in the right psoas muscle on this STIR image.

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4. Vertebral osteomyelitis

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Figure 23-4

Vertebral osteomyelitis.

A, B. Coronal and sagittal single-photon emission computed tomography (SPECT) bone scintigraphy images show abnormal increased uptake in the body on L5.

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5. Discitis

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Figure 23-5

Discitis.

A lateral radiograph of a 2-year-old child with a 14-day history of mild back pain shows narrowing of the L2-L3 disc space. The vertebral bodies are normal in appearance.

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6. Discitis

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Figure 23-6

Discitis.

A lateral radiograph of a 7-year-old male with 6 weeks of back pain demonstrates L3-L4 disc space narrowing, minimal endplate sclerosis, and an erosion in the L4 endplate.

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7. Discitis

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Figure 23-7

Discitis.

A sagittal CT image shows disc space narrowing at C3-C4 (arrow). The endplates are slightly irregular and there is an erosion in the anterior aspect of C4. The anterior paravertebral soft tissue is prominent. There is subtle thickening of the epidural soft tissue.

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8. Discitis

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Figure 23-8

Discitis.

There is abnormal increased uptake in 2 adjacent lumbar vertebrae (arrows) on this ...

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