Unusual Cause of Back Pain in a Multiple Myeloma Patient: Infectious Discitis
A 58 year old patient, followed up for diabetes mellitus and multiple myeloma for ten years and six months, respectively, presented with persistent back pain, weakness at his lower extremity and intermittent fever. Activation markers of myeloma were in normal limits except high erythrocyte sedimentation rate and elevated C-reactive protein. Magnetic resonance imaging revealed increased T1 spinal intensity at the suspected disc level. Discitis was suspected on the basis of MRl and high fever. An intraoperative examination of specimens revealed Staphylococcus aureus. Detailed laboratory and radiological investigations should be performed to diagnose unusual causes of persistent back pain, such as discitis in patients with myeloma.

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Authors: Şevki Kabak, Mustafa Çetin, Bülent Eser, Ali Ünal, Apdulhakim Coşkun

Keywords:

• Year: 2001
• Number: 4
• Referance No: 55899

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• 

  Figure 1. X-ray examination of the lumbosacral region: Third and fourth intervertebral disc space was narrowed and end plates of the vertebral bodies were sclerotic and irregular.
• 

  Figure 2a. Sagittal T1 weighted MR images show low signal intensity of the narrowing of the third and fourth lumbar vertebral bodies. Intervertebral disc and end plates were destructed
• 

  Figure 2b. Axial T1 weighted MR images at the level of the third and fourth intervertebral disc space revealed vacuum sign and contrast enhancement of the disc suggesting spondylodiscitis
• 

  Figure 3. Spondylodiscitis was drained surgically and a cage placed in the third and fourth intervertebral space.