PMC8571187_01
An X-ray/CT scan of the lumbar spine revealed the destructive pathological changes in the intervertebral space as well as in the adjacent plates of the L3 and L4 (ventrally>dorsally) resulting in the segmental kyphosis in the segment L3/4 on the lateral view. The loss of the disc space L3/4, especially on the right side could be seen in the anteroposterior scans/radiographs.
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F1
The standing X-ray revealed a segmental kyphosis as a result of the wedge deformity of L4-body and the collapsed disc space L3/4 [Figure 1].
An MRI of the lumbar spine showing an advanced spondylodiscitis L3/4 with the fluid signal in the disc as well as the collection of two abscesses (white arrows) in the right Psoas major muscle with the diffuse signal enhancement.
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F2
Furthermore, a diffuse signal enhancement in both psoas muscles and the autochthone muscles from L3 to S1 [Figure 2] was shown.
Abscess collection (white arrows) between the right Psoas major and inferior pole of the right kidney (left: Day 21, right: 6 weeks later).
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F3
A CT of the abdomen was performed on day 21, which showed increasing abscess collection in the right psoas major of 4.1 x 4.6 cm [Figure 3] but no signs of intraabdominal malignancy.
Standing X-ray of the lumbar spine, Follow-up: day 95.
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F4
The patient presented himself to the last follow-up at day 95 in perfect shape, without any symptoms, and further changes in the lumbar spine X-rays [Figure 4].