12 December 2012
Isolated septic facet joint arthritis as a rare cause of acute and chronic low back pain – a case report and literature reviewDominika Klekot, Anna Zimny, Bogdan Czapiga, Marek Sąsiadek
Pol J Radiol 2012; 77(4): 72-76
Background: The most common cause of low back pain is degenerative disease of the intervertebral disc and other structures of the lumbar spine. However, in some cases other less frequent causes of such pain can be seen, for example septic facet joint arthritis. Until now, only 40 cases of such inflammatory changes within the spine have been reported in the literature. The disease is probably underestimated due to improper diagnostic pathway.
Case Report: The authors describe a case of a 53-year-old woman who was repeatedly hospitalized during a five-month period because of an acute, severe low back pain, with sphincter dysfunction, partially resembling sciatic symptoms. Physical examinations revealed also focal tenderness in the area of the lumbar spine. Inflammatory markers (ESR – erythrocyte sedimentation rate, CRP – C-reactive protein) were elevated. Conservative analgetic treatment brought only partial and temporary relief of the pain and symptoms. The final accurate diagnosis of isolated septic facet joint arthritis at the level of L5/S1 was established after several months from the onset of the first symptoms, after performing various imaging examinations, including bone scintigraphy as well as CT and MRI of the lumbosacral spine. The patient fully recovered after antibiotic therapy and surgery, which was proven in several follow-up examinations showing no relevant pathology of the lumbar spine. The authors broadly describe the etiology and clinical symptoms of the septic facet joint arthritis as well as the significant role of imaging methods, especially MRI, in diagnostic process. The authors also discuss currently available treatment options, both conservative and surgical.
Conclusions: The diagnostic procedure of septic facet joint arthritis requires several steps to be taken. Establishing a correct diagnosis may be difficult, that is why it is important to remember about rare causes of low back pain and to perform detailed physical examination, laboratory tests and choose appropriate imaging techniques.
Keywords: low back pain, diagnostics, facet joint arthritis
01 December 2021 : EditorialEditorial: SARS-CoV-2 Vaccine Responses and Breakthrough COVID-19
Med Sci Monit 2021; 27:e935624
03 December 2021 : Laboratory ResearchInfluenza and Influenza-Like Respiratory Virus Infections in Children During the 2019/20 Influenza Season a...
Med Sci Monit In Press; DOI: 10.12659/MSM.934862
08 November 2021 : Database AnalysisVirtual Screening and Molecular Docking to Study the Mechanism of Chinese Medicines in the Treatment of Cor...
Med Sci Monit In Press; DOI: 10.12659/MSM.934102
01 November 2021 : EditorialEditorial: What Can be Learned from National and International Vaccine Adverse Event Reporting Systems Duri...
Med Sci Monit 2022; 28:e935299
07 Dec 2021 : Review articleA Review of the Impact of Neutrophils and Neutrophil Extracellular Traps (NETs) on the Development of Aorti...
Med Sci Monit In Press; DOI: 10.12659/MSM.935134
07 Dec 2021 : Review articleAdie’s Pupil: A Diagnostic Challenge for the Physician
Med Sci Monit In Press; DOI: 10.12659/MSM.934657
06 Dec 2021 : Animal ResearchAstragalus Flavone Induces Proliferation and Differentiation of Neural Stem Cells in a Cerebral Infarction ...
Med Sci Monit In Press; DOI: 10.12659/MSM.933830
Most Viewed Current Articles
20 Mar 2020 : Clinical ResearchSocial Capital and Sleep Quality in Individuals Who Self-Isolated for 14 Days During the Coronavirus Diseas...
Med Sci Monit 2020; 26:e923921
15 Apr 2020 : Clinical ResearchPsychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 20...
Med Sci Monit 2020; 26:e924171
05 May 2020 : Review articleAn Evidence Based Perspective on mRNA-SARS-CoV-2 Vaccine Development
Med Sci Monit 2020; 26:e924700