Abstract
A rare inflammation of the intervertebral disc and adjacent vertebral bodies should be taken into consideration in patients who complain of severe back pain combined with an elevated temperature with or without a neurological deficiency. Spondylodiscitis is as a rule associated with an elevated sedimentation rate and concentration of C-reactive protein.
Non-specific clinicaland laboratory signs with a normal picture for a prolonged period are mistaken for degenerative or tumourous affections ofthe spine. By meansofMR examination it is possible to diagnose reliably not only spondylodiscitis but also associated abscesses of nervous structure.
Based on results ofMR ofthe spine it is possible to elaborate a suitable therapeutic strategy- conservative or surgical. An early correct diagnosis will prevent serious mechanical or neuro- logical complications.
The authors describe the laborious search for the cause of crucial back pain in the first patient and elucidation of protracted fever in the second patient. In both instances the leading symptom was associated by a supplementary clinical attribute - in the first case subfebrile temperatures in the afternoon and in the second patient by marked lumbalgia.
After initial pain ofthe left knee, severe backache and fever, the course ofthe disease in te two patients was similar. The complicated search to diagnose the two-Ievel spondyldiscitis took 1.5 months.
The developed paravertebral abscesses had to be treated by surgery, while their early stages can be successfully treated by antibiotics only.