title: Lumbar facet joint septic arthritis presenting atypically as acute abdomen - A case report and review of the literature.
abstract: BACKGROUND
  Septic arthritis of the lumbar facet joints is uncommon. The clinical presentation is unusual and patients usually presents with acute back pain or with signs and symptoms mimicking acute abdomen.
  
  
  METHODS
  A 52year old man was admitted to the surgical ward with acute onset of abdominal pain and a provisional diagnosis of acute pyelonephritis. After the initial inconclusive investigations, magnetic resonance imaging was highly suggestive of lumbar facet joint septic arthritis. He was treated with intravenous antibiotics with complete resolution of infection.
  
  
  CONCLUSIONS
  The diagnosis of septic arthritis of facet joint is becoming more common with MRI scans. The clinical signs and symptoms are usually difficult to differentiate from acute spondylodiscitis. The commonest organism isolated is Staphylococcus aureus. A prompt and early diagnosis and treatment help to eradicate infection and prevent complications.
  
  
  CONCLUSIONS
  The atypical presentation of facet joint septic arthritis is one of the reasons why early diagnosis is elusive. Definitive diagnoses with MRI and bacterial culture as well as prolonged antibiotic therapy are recommended in this condition.
authors.affiliation: Associate Specialist in Trauma and Orthopaedics, Queen Elizabeth Hospital, Gateshead Health Foundation NHS Trust, Sheriff Hill, Gateshead, NE9 6SX, UK. Electronic address: asrajeev18@gmail.com.
authors.forename: Aysha
authors.initials: A
authors.lastname: Rajeev
authors.affiliation: Foundation Doctor in Trauma and Orthopaedics, Queen Elizabeth Hospital, Gateshead Health Foundation NHS Trust, Sheriff Hill, Gateshead, NE9 6SX, UK.
authors.forename: Nameer
authors.initials: N
authors.lastname: Choudhry
authors.affiliation: Junior Clinical Fellow in Trauma and Orthopaedics, Queen Elizabeth Hospital, Gateshead Health Foundation NHS Trust, Sheriff Hill, Gateshead, NE9 6SX, UK.
authors.forename: Mazharuddin
authors.initials: M
authors.lastname: Shaikh
authors.affiliation: Consultant in Radiology, Queen Elizabeth Hospital, Gateshead Health Foundation NHS Trust, Sheriff Hill, Gateshead, NE9 6SX, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Newby
keywords: Acute abdomen; Conservative treatment; Facet joint; Septic arthritis