PMC10025953_01
Patient's timeline.
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The patient's timeline is shown in Fig. 1.
Gadolinium enhanced, T1 weighted MRI of the lumbar spine showing abnormal enhancement of the L1-L2 endplates and paraspinal soft tissues.
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Laboratory evaluation revealed an erythrocyte sedimentation rate (ESR) of 96 mm/ 1 h (reference range: 0-22 mm/ 1 h), C-reactive protein (CRP) of 171 mg/L (reference range: <=8.0 mg/L) and MRI showed L1-L2 discitis and osteomyelitis (Fig. 2).
PET-CT scan showing L1-L2 discitis/osteomyelitis with progressive osseous destruction.
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Given the multifocal involvement, a PET-CT scan was obtained which revealed L1-L2 discitis/osteomyelitis with progressive osseous destruction and early paraspinal extension, in addition to multifocal FDG activity within the joints of the left ankle and foot (Fig. 3).