Discitis

Question 1

What is discitis?

Answer 1

Infection in the intervertebral disc space

Question 2

What are signs & symptoms of discitis?

Answer 2

Symptoms;

• Sever back pain
• Lack of mobility
• Young children; refuse to walk, arch back
• Start 1wk post-surgery

Question 3

What is the cause of discitis?

Answer 3

Debated;

• Haematogenous seeding of organism
• Direct spread

1. Spontaneous discitis - haematogenous spread (from UTI or RespI)
2. Post-operative complication - direct spread, usually from skin flora (eg staph aureus)

Question 4

How do you diagnose discitis?

Answer 4

• MRI; diagnostic air changes in dict
• XR/ CT; suggestive
• Biopsy; often hard to obtain
• Bloods; high CRP, high ESR

Question 5

How do you treat discitis?

Answer 5

• Antibiotics; potent due to poor vascularity of disc (IV ciprofloxacin, vancomysin)
• Reducing mobility due to pain; back brace, plaster cast
  
  • INC movement however increases blood flow and so is beneficial
  • ie SO MOVE AS CAN MOVE
• Without treatment an abscess may form which needs surgical correction