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Septic Arthritis of a Lumbar Facet Joint: Detection with Bone SPECT Imaging

Department of Radiology and Surgery, Morristown Memorial Hospital, Morristown, New Jersey

Correspondence: For reprints contact: Lawrence C. Swayne, MD, Dept. of Radiology, Morristown Memorial Hospital, 100 Madison Ave., Morristown, NJ 07960.

ABSTRACT

We present a rare case of septic arthritis of a lumbar facet joint with an associated epidural abscess resulting from Staphylococcus aureus. The infection was initially detected with planar bone scintigraphy and precisely localized with single photon emission computed tomography bone scintigraphy, despite an initially negative radiologic evaluation that included radiographs of the lumbar spine, lumbar myelography, and a postmyelography x-ray computed tomography scan. In the appropriate clinical setting, a bone scan demonstrating unilateral increased activity within the spine should raise the suspicion of inflammatory involvement of the posterior elements.