Septic facet joint arthritis after a corticosteroid facet injection.
Lumbar facet joint injections are commonly employed in the treatment of low back pain and are considered to be relatively safe with few known complications. We report the case of septic facet arthritis following a periarticular facet injection in a patient with recurrent urinary tract infections. The literature is reviewed to identify epidemiological and clinical features of patients in whom septic facet arthritis developed after lumbar facet injection. The diagnosis of iatrogenic septic facet arthritis is often delayed because neurologic and constitutional signs and symptoms develop slowly. Serologic nonspecific markers of infection and appropriate imaging studies may be more sensitive for the early diagnosis of septic facet arthritis. Recalcitrant or worsening back pain after facet injections should prompt an investigation to rule out infectious causes.
Department of Anesthesiology, Mayo Clinic College of Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA. weingarten.toby@mayo.edu
Toby N
TN
Weingarten
W Michael
WM
Hooten
Marc A
MA
Huntoon
D000038:Abscess / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D001168:Arthritis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D042241:Early Diagnosis; D004926:Escherichia coli; D004927:Escherichia coli Infections / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D017116:Low Back Pain / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018579:Patient Selection; D011859:Radiography; D014552:Urinary Tract Infections / Q000150:complications / Q000503:physiopathology; D021801:Zygapophyseal Joint / Q000187:drug effects* / Q000503:physiopathology
D000305:Adrenal Cortex Hormones