Demographics:
46 years old, Female
Indication:
Lower back pain
Findings
- T2/STIR hyperintense signal and enhancement in the right L4-L5 facet joint extending into the adjacent articular pillars and L4 and L5 pedicles
- T2/STIR hyperintense signal and enhancement in the surrounding right posterior paraspinal soft tissues and musculature without peripherally enhancing collection
- T2/STIR hyperintense signal and enhancement in the anterior aspects of the L2 inferior endplate and L3 superior endplate without intervening disc signal abnormality
- Mild multilevel facet hypertrophy without significant spinal canal or neural foraminal stenosis
- No epidural collection
Diagnosis
Septic facet arthritis
Sample Report
Findings consistent with septic arthritis involving the right L4-L5 facet joint with associated osteomyelitis involving the adjacent articular pillars and L4 and L5 pedicles. No epidural abscess or significant associated spinal canal or neural foraminal compromise. Adjacent myositis without soft tissue abscess.
T2/STIR hyperintense signal and enhancement in the anterior aspects of the L2 inferior endplate and L3 superior endplate, which is favored degenerative in etiology given lack of abnormal disc signal. Recommend attention on follow-up imaging.
Mild multilevel facet hypertrophy without significant spinal canal or neural foraminal stenosis.
Discussion