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    Go to the top of the page   ID: 20030610135616 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Spondylodiscitis L4/5
    Dirk Schaper, V Hofmann. Spondylodiscitis L4/5. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030610135616


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper, V. Hofmann (Halle/S.)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    4 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    Spinal canal / Myelon  

     
     Pediatric Radiology CasesMost likely etiology:

    inflammatory or infectious  

     
     Pediatric Radiology CasesHistory:

    4 year-old boy with pain in the right hip after fall. Shooting pain with inability to walk. The patient presented uncharacteristic symptoms various times in several institutions. Patient refused to sit or stand. Presentation to child- and juvenile psychologists. Presentation in our clinic because of continuing pain. CRP and ESR were increased, further values were normal. Pain in the right proximal thigh. Notable waddling gait, hyperlordosis of the lumbar spine.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Probably inflammatory origin.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-ray 1: Obvious narrowing of the intervertebral space L4/5






    MRI 1 <- view MRI 1

    MRI 1: T1: steep presentation of the spinal column, signal reduction in L4 and L5. Narrowed disc, dorsal protrusion into the spinal column.






    MRI 2 <- view MRI 2

    MRI 2: T2 clear signal increase in the corresponding vertebral bodies and in the disc L4/5






    MRI 3 <- view MRI 3

    MRI 3: after treatment, no proof of inflammatory changes. Obvious flattening of the disc.





     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Total constellation (Consens)  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Spondylitis, Vertebral body osteomyelitis  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Immobilization in bed and antibiotic treatment in spite of missing pathogenic proof. Fitting of a corset. Slow decline of the BSR. Further immobilization in the corset also in the mobilization phase. Increased mobilization in the course of the illness, trouble-free gait. In the follow-up MR image, proof of the narrowing disc. At present, the paitent reports no troubles, and has a full sport capacity.  

     
     Pediatric Radiology CasesComments of the author about the case:

    The patient's history and the progress of the patient fits well with some already-published cases. The typical "not wanting to stand or sit" is, in otherwise uncharacteristic symptoms, not a strong enought statement to make a diagnosis. One should give this main symptom of Spondylodiscitis more notice, in order to avoid long misleading courses. The necessity of an antibiotic therapy is still disputed. We have opted for it, on the basis of the obvious BSR increase and subfebrile temperatures.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    W.Grosch, W.Weigel, M.Gahr
    Spondylodiszitis im Kindesalter
    Monatsschr Kinderheilkd (1995)143:481-485

    2. Medline: Medline
    A.H.Crawford, D.W. Kucharzyk, R.Ruda, H.C.Smitherman
    Diskitis in children
    Clin Orthop 266:70-79  

     
     Pediatric Radiology CasesKeywords:

    Spondylodiscitis, lumbar, L4/5 Spondylodiscitis, shooting pain, fall, elevated ESR, elevated CRP, vertebral disc inflammation, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper, V Hofmann. Spondylodiscitis L4/5. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030610135616  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Spinal canal / Myelon
    or in the region: Spinal canal / Myelon
    or in the tissue/organ:
    or with the etiology: inflammatory or infectious
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Spondylodiscitis L4/5
    Dirk Schaper, V Hofmann. Spondylodiscitis L4/5. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030610135616


     

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    Spondylodiscitis L4/5
    Other cases by these authors:

    Search Dirk Schaper in Medline Dirk Schaper (43)   
    Search V. Hofmann in Medline V. Hofmann (17)   

    Spondylodiscitis L4/5  
     
    Spondylodiscitis L4/5
    Dirk Schaper, V Hofmann. Spondylodiscitis L4/5. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030610135616


     

    Which diagnosis have other collegues guessed?


    • Spondylitis
      Votes: 2 (8 %)


    • Spondylodiscitis
      Votes: 19 (82 %)


    • Ewingsarcoma
      Votes: 1 (4 %)


    • Osteosarcoma
      Votes: 1 (4 %)



        Total answers: 23

     
    Spondylodiscitis L4/5
    Dirk Schaper, V Hofmann. Spondylodiscitis L4/5. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030610135616


     

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    Spondylodiscitis L4/5
    Dirk Schaper, V Hofmann. Spondylodiscitis L4/5. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030610135616


     




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