Diskitis, vertebral osteomyelitis
It is hard for an infection to start directly from the disk space but it will get there through the blood. Diskitis is more frequent in developing countries. The cause of the infection may be soft-tissue infection or pneumonia.
It is very important to diagnose diskitis quickly because diskitis can be a cause of decease when the infection spreads. The bad news is that diskitis has a slow and quiet evolution, and often the patient finds out that he suffers from diskitis after a long time. The first symptoms are : back pain and neck pain, and the pain becomes stronger when the person tries to move. Another sign is that the pain doesn’t disappear with normal pain killers. In children, the illness is more radical and fever may also appear. Both mature and young patients present sensitivity in the area and muscles spasm and also a low mobility (especially when lumbar or cervical areas are involved).
When a patient suffers from diskitis, C-reactive protein and a high rate of erythrocyte sedimentation are found . Blood tests have to become a routine for persons who may suffer from diskitis. Urine cultures are also needed in order to find other possible infections.
In order to set the diagnose, a radiography is needed because abnormalities are discovered, the bad part is that they are discovered only after two or three weeks. For a more rapid and early discovery of the diskitis, a CT scan may be performed. CT scan has another advantage because using it the doctor may also discover others par spinal diseases. Also the nuclear medicine can help in the discovery of diskitis, by using Gallium-67 or technetium-99m. more specific for diskitis is the MRI test and when a substance of contrast is used, with the MRI can also be located par spinal diseases.
The treatment with antibiotics may be adaptive depending on each case . For the ESR to drop the treatment will include the parenteral treatment for 8 weeks. Also bed rest is recommended at the beginning of the illness. And after the seven or ten days in bed, when the patient goes out it’s better to use something for local immobilization.
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