Demographics:
56 years old, Female
Indication:
Neck swelling, fever
Findings
- Large, peripherally enhancing, multiloculated collection involving the retropharyngeal and prevertebral spaces extending from the C2-T4 levels, which exerts significant mass effect on and markedly narrows the supraglottic airway
- Endplate erosive changes about the C6-C7 disc with associated disc space widening posteriorly and focal kyphosis. There is also widening of the posterior aspects of the C6-C7 facet joints
- The fluid collection encases the left vertebral artery, which remains patent, and also abuts the right vertebral artery and bilateral carotid spaces
Diagnosis
Prevertebral abscess
Discitis
Sample Report
Large prevertebral abscess measuring 7 x 5 x 15 cm which extends from the levels of C2-T4 (slightly into the superior mediastinum posteriorly), which exerts mass effect on and markedly narrows the supraglottic larynx.
No gas within this collection to suggest communication with the esophagus.
C6-C7 endplate erosive changes with posterior disc space and bilateral facet joint widening. Findings are concerning for contiguous discitis/osteomyelitis, which could be further evaluated with C-spine MRI with and without contrast.
The above described abscess encases the left vertebral artery and abuts the right vertebral artery and carotid spaces without significant stenosis or evidence of thrombosis.
Discussion