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Case of the Week 1 2022

*55-years-old patient with low back pain and fever.

What is the most likely diagnosis?

Answer

Answer: Facet joint septic arthritis

Case Discussion:

Facet joint septic arthritis is a rare serious entity. It can be secondary to disc or vertebral infection. An isolated form of facet joint septic arthritis should raise suspicion of the septic cause, especially in diabetic or immunocompromised patients via a hematogenous spread of extra-spinal infections, tuberculosis, or iatrogenic cause (facet joint injection).

Facet joint septic arthritis can show paraspinal or epidural extension. In our case, it showed paraspinal muscular and epidural extension with the formation of a small epidıral abscess.

References:

1. Romain Perolat, Adrian Kastler, Benjamin Nicot, Jean-Michel Pellat, Florence Tahon, Arnaud Attye, Olivier Heck, Kamel Boubagra, Sylvie Grand, Alexandre Krainik. Facet joint syndrome: from diagnosis to interventional management. (2018) Insights into Imaging. 9 (5): 773.