Abstract
The diagnosis of discitis is difficult because it often mimics other diseases such as tenosynovitis, septic arthritis, and osteomyelitis. Intervertebral disc space narrowing, the hallmark of this disease, may not be radiologically evident for 8-10 weeks. Although discitis is considered an infectious process, biopsies are generally obtained late in the disease, are culture negative, and show nonspecific inflammation. In a 3-year prospective analysis of 9 patients with suspected discitis, 7 were confirmed as discitis, 1 had sacroiliac septic arthritis, and 1 had Guillain-Barré syndrome. The mean age was 3.3 yr and 5/7 were girls. Routine spine x-rays were not positive for 6-10 weeks. Gallium citrate and technetium diphosphanate scans were diagnostic (9/9) within 7 and 14 days of symptoms, respectively. Scans were diagnostic on 7 occasions when standard x-rays were not. Anaerobic diphtheroids were isolated from one disc space and streptococci from another. Spica casts were used in 6/7 patients to encourage immobilization, antibiotics in 2/7, and 1 received no specific therapy. All patients recovered. The present study is the first known prospective analysis of discitis. These data suggest that this disease is more common than previously recognized and that radiopharmaceuticals may be used to accurately diagnose discitis. Pediatricians are urged to consider this diagnosis in any child with fever, irritability, and vague abdominal, leg, or back complaints whose etiology is not identified.
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Fischer, G., Popich, G., Sullivan, D. et al. DISCITIS: NEW DIAGNOSTIC TECHNIQUES. Pediatr Res 11, 499 (1977). https://doi.org/10.1203/00006450-197704000-00778
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DOI: https://doi.org/10.1203/00006450-197704000-00778
