• William M Ursprung, Norman W Kettner, and Ron Boesch.
• Department of Radiology, Logan College of Chiropractic, Chesterfield, MO 63006-1065, USA. william.ursprung@logan.edu
• J Manipulative Physiol Ther. 2005 Nov 1; 28 (9): 713-8.

ObjectiveTo report and discuss a case of vertebral osteomyelitis presenting to a chiropractic clinic.Clinical FeaturesA 65-year-old man presented to a chiropractic clinic with acute low back pain. A lumbar spine magnetic resonance image was obtained with and without contrast in both the sagittal and axial planes. The diagnostic impression was osteomyelitis and discitis across the L2-3 disk space with epidural abscess posterior to L3 and a paravertebral abscess. The patient was referred for medical management. A computed tomography-guided fine needle aspiration was performed and confirmed a Staphylococcus aureus infection. The L2-3 level was surgically debrided and fused after a regimen of antibiotic therapy.ConclusionsThis case report presents a typical clinical presentation of vertebral osteomyelitis and reviews the diagnostic imaging, pathophysiology of spontaneous vertebral osteomyelitis, and treatment options in the management of this condition.

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