Ab0166 Contribution of Imaging in Infectious Spondylodiscitis in the Cap Bon Region of Tunisia

Background: Infectious spondylodiscitis (IS) remains a diagnostic and therapeutic emergency that can impact a patient's vital and functional prognosis through various complications. The contribution of imaging in IS is fundamental. Objectives: The aim of our work is to describe the radiological aspects of IS in the Cap Bon region of Tunisia. Methods: This is a retrospective study carried out in the internal medicine department of the Mohamed Taher Maamouri University Hospital in Nabeul during the period from January 2018 to January 2023, grouping patients hospitalized for IS. Results: We identified 53 cases of IS over a 5-year period divided into 39 men and 14 women with a sex ratio M/F = 2.78. The mean age of the patients was 59.49 ± 11.71. 42 patients had pyogenic spondylodiscitis (79.24% of cases), 7 had tuberculous spondylodiscitis (13.2% of cases), and 4 had brucellian spondylodiscitis (7.5% of cases). Spinal radiographs were taken in only ten cases. They were pathological in seven cases, showing signs suggestive of IS: disc pinching in 6 cases, mirror-like erosions of the vertebral plates in 4 cases, effacement of the vertebral plates in 2 cases, and vertebral osteolysis in one case. Spinal CT scans were performed in 31 patients (58.49%). It was pathological in all cases, showing: effacement of the vertebral plates in 8 cases, mirrored erosions of plates in 6 cases, subchondral geodesia in 7 cases, vertebral osteolysis in 9 cases, disc pinching in 10 cases, disc void in 2 cases, paravertebral soft-tissue thickening in 11 cases, paravertebral abscess in 14 cases, epiduritis in 18 cases, and spinal cord compression in 6 cases. MRI was performed in 49 cases (92.45%). It showed pathological images of IS in all cases in which it was performed. The abnormalities observed were: T1 hyposignal of vertebral bodies in 31 cases (65.26%), T2 hypersignal of vertebral bodies in 31 cases (65.26%), disc pinching in 29 cases (59.18%), Gadolinium uptake in 32 cases (62.3%), soft tissue thickening in 22 cases (44.89%), paravertebral soft-tissue abscess in 13 cases (24.5%), epiduritis in 27 cases (55.1%), epidural abscess in 8 cases (16.32%), spinal cord compression in 13 cases (26.53%), posterior arch involvement in 2 cases (3.8%) and sacroiliac involvement in 2 cases (3.8%). Conclusion: MRI is the gold standard for the diagnosis of IS. It enables early diagnosis when even standard radiographs or CT scans are normal. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.