Magnetic resonance imaging in the early phase of pyogenic spondylitis: A report of four cases

Abstract

Magnetic resonance imaging (MRI) is useful for the early diagnosis of pyogenic spondylitis, because it clearly demonstrates edema and inflammatory changes. However, in four of our patients, MRI revealed no clear abnormality and it was difficult to make a diagnosis at the first hospital visit; evidence of pyogenic spondylitis was obtained later. Changes on plain roentgenogram and MRI were investigated at various times over the course of the disease in these patients. Since abnormalities may not be detected by MRI in the early phase of this disease, we recommend that imaging be repeated after at least 2 weeks if no abnormalities are noted at the first hospital visit in patients in whom this disease is suspected because of clinical or laboratory findings.