A 70-year-old man consults for non-radiating lumbar pain of 1 week's duration, of progressive intensity, accompanied by marked limitation of spinal mobility and febrile fever. The lumbar spine X-ray shows no alterations. What diagnosis should we rule out first and with what technique?
We suspect spondylodiscitis - the febrile fever and the limitation of mobility of the spine with the acute course give the key -, and the indicated test is the MRI. "The most demonstrative test is magnetic resonance imaging (MRI), which is positive even in the first 2 weeks of the picture, which facilitates early diagnosis, with a sensitivity of 90%". Vertebral crushing would be seen in the simple X-ray, as well as vertebral ankylosing hyperostosis and many metastases. In addition, there is no data in the history pointing to bone metastases (oncologic history, weight loss etc).
Vertebral crush with computed tomography (CT).
Bone metastases with technetium bone scan.
Vertebral ankylosing hyperostosis with dorsolumbar spine x-ray.
Pyogenic spondylodiscitis with magnetic resonance imaging (MRI).
Vertebral crushing would be seen in the simple X-ray, as well as vertebral ankylosing hyperostosis and many metastases.
there is no data in the history pointing to bone metastases (oncologic history, weight loss etc).
Vertebral crushing would be seen in the simple X-ray, as well as vertebral ankylosing hyperostosis and many metastases.
We suspect spondylodiscitis - the febrile fever and the limitation of mobility of the spine with the acute course give the key -, and the indicated test is the MRI.