Summary about Disease
Diskitis, also spelled discitis, is an inflammation of the intervertebral disc space, the area between the vertebrae in the spine. It is most commonly seen in children, but can also occur in adults. It is often, but not always, caused by an infection.
Symptoms
Back pain (most common)
Refusal to walk or sit (in children)
Limping (in children)
Abdominal pain
Fever (may be present, especially in children)
Stiffness in the back
Irritability
Causes
Infection: The most common cause, typically bacterial (e.g., Staphylococcus aureus*). Infection can spread to the disc from elsewhere in the body.
Post-surgical: Diskitis can occur as a complication of spinal surgery.
Unknown: In some cases, the cause remains undetermined (idiopathic).
Medicine Used
Antibiotics: Primarily used for bacterial diskitis. The specific antibiotic depends on the identified organism. Intravenous antibiotics are often used initially, followed by oral antibiotics.
Pain relievers: Medications like NSAIDs (ibuprofen, naproxen) or acetaminophen may be used for pain management. In severe cases, stronger pain medications (opioids) might be considered.
Muscle relaxants: These can help alleviate muscle spasms associated with back pain.
Is Communicable
Diskitis itself is generally not communicable. If the cause is a bacterial infection, the underlying infection may be communicable through standard routes (e.g., respiratory droplets for some bacteria), but the diskitis that results from the infection is not directly transmitted from person to person.
Precautions
Good hygiene: Practicing good hygiene, such as regular handwashing, can help prevent infections that could potentially spread to the spine.
Prompt medical attention: Seek prompt medical attention for back pain, especially if accompanied by fever or other concerning symptoms.
Post-surgical care: Following post-operative instructions carefully after spinal surgery can reduce the risk of complications, including diskitis.
How long does an outbreak last?
The duration of diskitis can vary significantly. With appropriate antibiotic treatment, symptoms may begin to improve within a few days. However, the full course of treatment can last for 6-12 weeks or longer, depending on the severity of the infection and the individual's response. The inflammatory process and associated pain might linger even after the infection is cleared.
How is it diagnosed?
Physical examination: Assessment of back pain, range of motion, and neurological function.
Blood tests: To check for signs of infection (e.g., elevated white blood cell count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]).
Imaging studies:
MRI: The most sensitive imaging modality for detecting diskitis. It can show inflammation of the disc space and adjacent vertebral bodies.
X-rays: May show narrowing of the disc space, but are less sensitive than MRI, especially in the early stages.
CT scan: Can provide detailed images of the bones of the spine.
Disc aspiration/biopsy: In some cases, a sample of fluid or tissue from the disc space may be taken for culture and analysis to identify the specific organism causing the infection.
Timeline of Symptoms
The timeline can vary:
Initial Phase: Back pain is usually the first symptom. In children, this might manifest as refusal to walk or sit.
Progression: As the inflammation increases, pain may worsen, and stiffness can develop. Fever may appear, particularly in infectious cases.
Diagnosis & Treatment: Diagnosis usually occurs within a few weeks to months of symptom onset. Antibiotic treatment (if applicable) aims to reduce inflammation and control infection. Pain relief measures are typically implemented simultaneously.
Recovery: Improvement with treatment may be gradual, with pain decreasing over weeks to months. Full recovery can take several months, and sometimes longer, depending on the severity and individual factors.
Important Considerations
Early diagnosis and treatment are crucial to prevent long-term complications, such as spinal deformity or chronic pain.
MRI is the preferred imaging modality for diagnosing diskitis.
Prolonged antibiotic therapy is often necessary to eradicate the infection.
Immobilization of the spine (e.g., with a brace) may be recommended to reduce pain and promote healing.
Follow-up care is essential to monitor progress and ensure complete resolution of the infection and inflammation.