Investigations

• radiology:
  • the most often affected vertebrae are T10-l1
  • initial x-ray investigation may only reveal osteoporosis with narrowing of the disc space
  • as the condition proceeds radiology shows bone destruction without the periosteal reaction so typical of pyogenic infection. In addition to narrowing of the disc space, collapse of the anterior portions of the vertebral bodies and sometimes the delineation of a clear paravertebral abscess

There is an increased erythrocyte sedimentation rate and a positive Mantoux test.

Note that whereas thoracic spine paraspinal abscesses may be seen on x-ray, lumbar paraspinal abscesses may be in the flank, by the psoas muscle, or in the iliac fossa.