Abstract
Native vertebral osteomyelitis (NVO) is a potentially fatal infection which has seen a gradual increase in its incidence over the past decades. The infection is insidious, presenting with symptoms of back pain. Fever is present in about 60 % of patients. Prompt diagnosis of NVO is important to prevent the development of complications. Numerous laboratory and imaging tools can be deployed to accurately establish the diagnosis. Imaging techniques such as magnetic resonance, nuclear imaging, and computed tomography are essential in diagnosing NVO but can also be useful in image-guided biopsies. Laboratory tools include routine blood tests, inflammatory markers, and routine culture techniques of aspirated specimens. Recent advances in molecular techniques can assist in identifying offending pathogen(s). In this review, we detail the arsenal of techniques that can be utilized to reach a diagnosis of NVO.
Highlights
Native vertebral osteomyelitis (NVO), termed spondylodiscitis, is a potentially fatal condition that constitutes roughly 3 %–5 % of all osteomyelitis cases (Sobottke et al, 2008)
Due to relative rarity and nonspecific symptoms, delays in the diagnosis of NVO still happen despite the expanding use and availability of magnetic resonance imaging (MRI)
This review summarizes the literature on the various diagnostic modalities employed to diagnose NVO
Summary
Native vertebral osteomyelitis (NVO), termed spondylodiscitis, is a potentially fatal condition that constitutes roughly 3 %–5 % of all osteomyelitis cases (Sobottke et al, 2008). Due to relative rarity and nonspecific symptoms, delays in the diagnosis of NVO still happen despite the expanding use and availability of magnetic resonance imaging (MRI). A prospective study on NVO found a mean diagnostic delay of 45.5 d from the onset of symptoms (range 2–280 d). Highly sensitive (86 %), this symptom lacks specificity, among older adults. Other symptoms of NVO, such as fever (60 %) and neurologic deficits, including radiculopathy, urinary retention, limb weakness, paralysis, dysesthesia, or sensory loss (34 %) are less common (Mylona et al, 2009). There are no widely agreed upon diagnostic criteria for diagnosing NVO, in cases with negative blood and biopsy cultures. NVO is diagnosed through a compatible overall clinical picture, combined with suggestive imaging and laboratory findings (Berbari et al, 2015). This review summarizes the literature on the various diagnostic modalities employed to diagnose NVO
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