Infectious arthritis

Author: Vijay Shankar, M.D. (see Authors page)

Revised: 23 August 2017, last major update March 2013

Copyright: (c) 2002-2017,, Inc.

PubMed Search: Infectious arthritis spondylodiskitis

Cite this page: Shankar, V. Spondylodiskitis. website. Accessed August 15th, 2018.
Definition / general
  • Inflammation of intervertebral disk tissue and adjacent vertebrae, which are normally resistant to infection due to avascularity
  • Usually associated with back pain (since involves lumbar segments), ages 50+ years, male predominance
  • Spondylodiskitis commonly involves lumbar (45%), thoracic (35%), and cervical (10 - 20%) spine; causes secondary epidural abscess most commonly in cervical spine, also thoracic and lumbar spine
  • Increased frequency of diagnosis due to magnetic resonance imaging
  • Most cases are due to pyogenic organisms (Staph, Strep); also Candida, Aspergillus, Cryptococcus, Mycobacterium tuberculosis; rarely Enterococcus
  • Culture usually positive (78%), special stains are usually negative
Radiology images

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Destruction of vertebral bodies and disk tissue

Case reports
Gross images

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Intervertebral disc
(top center) destroyed
by vertebral abscess

Spinal cord compressed by abscess

Microscopic (histologic) description
  • Vascularization, myxoid degeneration, necrosis of disk, chronic osteomyelitis
  • Variable acute osteomyelitis (25%), granulation tissue
  • Tuberculous infection has caseating granulomas
Microscopic (histologic) images

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Fig. G & H: inflammatory cells and bacteria

C. tropicalis