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A Rare Cause of Low Back Pain: A Challenging Diagnosis

One of the rarest causes of low back pain is septic arthritis of a lumbar facet joint. We report the case of a 92-year-old diabetic woman with a history of four days of back pain, dysuria, and fever. Due to a sudden worsening of lumbar pain, she went to the emergency department. Physical exam reveal...

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Detalles Bibliográficos
Autores principales: Beirão, Tiago, Reis, Jorge, Cochicho, Joana, Costa, Francisca, Malheiro, Luís, Videira, Taciana, Pimenta, Joana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9360998/
https://www.ncbi.nlm.nih.gov/pubmed/35959179
http://dx.doi.org/10.7759/cureus.26709
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author Beirão, Tiago
Reis, Jorge
Cochicho, Joana
Costa, Francisca
Malheiro, Luís
Videira, Taciana
Pimenta, Joana
author_facet Beirão, Tiago
Reis, Jorge
Cochicho, Joana
Costa, Francisca
Malheiro, Luís
Videira, Taciana
Pimenta, Joana
author_sort Beirão, Tiago
collection PubMed
description One of the rarest causes of low back pain is septic arthritis of a lumbar facet joint. We report the case of a 92-year-old diabetic woman with a history of four days of back pain, dysuria, and fever. Due to a sudden worsening of lumbar pain, she went to the emergency department. Physical exam revealed pain with pressure over the D12 vertebral apophyses and the lower-left paraspinal musculature. Laboratory data showed a normochromic normocytic anemia with a hemoglobin of 9.3 g/dL, white cell count of 14.61x10e3/µL (83.1% neutrophils), serum creatinine 1.46 mg/dL and C-reactive protein of 32.11 mg/dL. In urinalysis, nitrites and leukocyturia were identified. CT scan showed an acute D12 fracture and fat stranding at L5, with no irregularities in the discs or in other lumbar spaces. Escherichia coli was isolated in blood culture. Lumbar MRI confirmed the diagnosis of septic arthritis of an L5-S1 facet joint and L5 vertebrae osteomyelitis. The patient was successfully treated with intravenous ceftriaxone for eight weeks. As far as we know, this is the second report of septic arthritis of the facet joint caused by Escherichia coli.
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spelling pubmed-93609982022-08-10 A Rare Cause of Low Back Pain: A Challenging Diagnosis Beirão, Tiago Reis, Jorge Cochicho, Joana Costa, Francisca Malheiro, Luís Videira, Taciana Pimenta, Joana Cureus Radiology One of the rarest causes of low back pain is septic arthritis of a lumbar facet joint. We report the case of a 92-year-old diabetic woman with a history of four days of back pain, dysuria, and fever. Due to a sudden worsening of lumbar pain, she went to the emergency department. Physical exam revealed pain with pressure over the D12 vertebral apophyses and the lower-left paraspinal musculature. Laboratory data showed a normochromic normocytic anemia with a hemoglobin of 9.3 g/dL, white cell count of 14.61x10e3/µL (83.1% neutrophils), serum creatinine 1.46 mg/dL and C-reactive protein of 32.11 mg/dL. In urinalysis, nitrites and leukocyturia were identified. CT scan showed an acute D12 fracture and fat stranding at L5, with no irregularities in the discs or in other lumbar spaces. Escherichia coli was isolated in blood culture. Lumbar MRI confirmed the diagnosis of septic arthritis of an L5-S1 facet joint and L5 vertebrae osteomyelitis. The patient was successfully treated with intravenous ceftriaxone for eight weeks. As far as we know, this is the second report of septic arthritis of the facet joint caused by Escherichia coli. Cureus 2022-07-10 /pmc/articles/PMC9360998/ /pubmed/35959179 http://dx.doi.org/10.7759/cureus.26709 Text en Copyright © 2022, Beirão et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Radiology
Beirão, Tiago
Reis, Jorge
Cochicho, Joana
Costa, Francisca
Malheiro, Luís
Videira, Taciana
Pimenta, Joana
A Rare Cause of Low Back Pain: A Challenging Diagnosis
title A Rare Cause of Low Back Pain: A Challenging Diagnosis
title_full A Rare Cause of Low Back Pain: A Challenging Diagnosis
title_fullStr A Rare Cause of Low Back Pain: A Challenging Diagnosis
title_full_unstemmed A Rare Cause of Low Back Pain: A Challenging Diagnosis
title_short A Rare Cause of Low Back Pain: A Challenging Diagnosis
title_sort rare cause of low back pain: a challenging diagnosis
topic Radiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9360998/
https://www.ncbi.nlm.nih.gov/pubmed/35959179
http://dx.doi.org/10.7759/cureus.26709
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