title: Acute symptomatic calcific discitis in adults: a case report and review of literature.
abstract: Symptomatic calcific discitis has been reported in the paediatric population but is a rare entity in adults with only eight cases reported in the English literature. We present a case of adult calcific discitis presenting with acute onset back pain. Radiographs and CT demonstrated central T11-T12 disc calcification with diffuse marrow oedema on subsequent MRI. The patient was referred to our spinal oncology unit due to the extensive marrow oedema as a possible underlying primary bone tumour. Review of the CT confirmed an end-plate defect with herniated calcific nucleus pulposus with no underlying bone lesion. Features were in keeping with acute calcific discitis. The patient was treated symptomatically and made an uneventful recovery. We discuss the characteristic imaging features seen on radiograph, CT and MRI and review the current literature. Calcific discitis is a self-limiting pathology requiring symptomatic management only. Radiologists need to be aware of this rare entity as it can occur in adults and may be mistaken for a more sinister pathology such as infective discitis or a bone tumour and lead to further unnecessary imaging or invasive procedures.
authors.affiliation: Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, B31 2AP, UK. doctigs@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Shah
authors.affiliation: Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, B31 2AP, UK.
authors.forename: R
authors.initials: R
authors.lastname: Botchu
authors.affiliation: Department of Spinal Oncology, Royal Orthopaedic Hospital, Birmingham, UK.
authors.forename: M F
authors.initials: MF
authors.lastname: Grainger
authors.affiliation: Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, B31 2AP, UK.
authors.forename: A M
authors.initials: AM
authors.lastname: Davies
authors.affiliation: Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, B31 2AP, UK.
authors.forename: S L
authors.initials: SL
authors.lastname: James
mesh_terms: D000208:Acute Disease; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology*; D003937:Diagnosis, Differential; D015299:Discitis / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D011859:Radiography; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: Acute discitis; Adult; Calcific discitis; Intervertebral disc; Nucleus pulposus