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Diskitis, Pediatric

Melissa L. Mannion, MD, MSPH and Randy Q. Cron, MD, PhD Reviewed 10/2018
 


BASICS

DESCRIPTION

Often benign, self-limited inflammatory process of an intervertebral disk 

EPIDEMIOLOGY

>50% of the cases occur in children <4 years of age. 

Incidence

  • Peak incidence is between 0 ...

DIAGNOSIS

HISTORY

  • Uncomfortable, irritable child

  • Refusal to walk

  • Fever

  • Back or abdominal pain

  • Symptoms of short duration prior to presentation

PHYSICAL EXAM

  • Usually, rigid posture and pain elicited on moveme...

TREATMENT

MEDICATION

  • Usually quite responsive to NSAIDs

  • Toddlers are usually treated with antibiotics for S. aureus and Kingella.

SURGERY/OTHER PROCEDURES

Surgery indicated for compression of neural eleme...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • When to expect improvement: Most patients are asymptomatic in 6 to 8 weeks.

  • Signs to watch for:

    • Recurrence of symptoms due to reactivation of the ...

ADDITIONAL READING

  • Arthurs OJ, Gomez AC, Heinz P, et al. The toddler refusing to weight-bear: a revised imaging guide from a case series. Emerg Med J.  2009;26(11):797–801. [View Abstract on Ovid...

CODES

ICD9

  • 722.90 Other and unspecified disc disorder, unspecified region

  • 722.93 Other and unspecified disc disorder, lumbar region

  • 722.91 Other and unspecified disc disorder, cervical region

  • 722.92 Other...

FAQ

  • Q: When are a biopsy and tissue culture indicated?

  • A: If there is bony destruction of adjacent vertebral bodies, if clinical course is prolonged or recurrent, or if the lesion mimics a tumor

  • Q: When...

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