Spondylodiscitis in patients with spinal cord compression: a possible pitfall in radiation oncology

Radiother Oncol. 2001 Jun;59(3):307-9. doi: 10.1016/s0167-8140(00)00300-5.

Abstract

Purpose: In patients presented for spinal irradiation it may be difficult to distinguish between malignant and benign lesions if only plain X-rays and computed tomography (CT)-scans are available. Spinal magnetic resonance imaging (MRI) can be of great diagnostic value.

Methods: From 11/1995 to 05/2000 447 patients were presented for spinal irradiation, 264 beyond regular operating hours. At presentation no spinal MRI was available in 170/447 and 132/264 patients.

Results: After spinal MRI, diagnosis was changed from vertebral metastases to spondylodiscitis in 10/170 and 8/132 patients. Six of these patients were already known as cancer patients.

Conclusion: In patients presented for spinal irradiation spondylodiscitis is not very uncommon. If there is any doubt about metastatic disease as the cause for spinal cord compression a spinal MRI has to be demanded, even beyond regular operating hours.

MeSH terms

  • Aged
  • Cervical Vertebrae / diagnostic imaging
  • Diagnosis, Differential
  • Discitis / complications*
  • Discitis / diagnosis
  • Female
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / diagnosis
  • Neoplasms / radiotherapy
  • Radiation Oncology
  • Radionuclide Imaging
  • Spinal Cord Compression / complications*
  • Spinal Cord Compression / diagnostic imaging*
  • Thoracic Vertebrae / diagnostic imaging
  • Tomography, X-Ray Computed / methods