INFECTIOUS DISCITIS DIAGNOSTIC CONTRIBUTION OF LABORATORY TESTS AND PERCUTANEOUS DISCOVERTEBRAL BIOPSY - A REVIEW OF 120 CASES

Clinical and laboratory findings in 120 patients with suspected discit is (loss of disk height and erosions of the vertebral endplates on pla in radiographs) were reviewed and compared with percutaneous discovert ebral biopsy results. Patients were categorized into three groups base d on whether the symptoms developed after an invasive procedure (Group I), during septicemia (Group II), or spontaneously (Group III). Group II patients were more likely to have fever and had higher mean erythr ocyte sedimentation rate and C-reactive protein values. A pathogen was recovered in the biopsy specimen in 34%, 60.7%, and 43.5% of patients in groups I, II, and III, respectively. Specific histologic changes w ere seen in 49%, 42.8%, and 51.3% of cases, respectively. The combinat ion of clinical, laboratory test, and biopsy findings established the diagnosis of pyogenic discitis in 74 cases (62.5%), tuberculous discit is in nine cases (7.5%), and degenerative pseudodiscitis in 37 cases ( 30%). Percutaneous biopsy had a sensitivity of 72% and a specificity o f 94%. Percutaneous discovertebral biopsy is helpful for the diagnosis of infectious discitis and should be done whenever this condition is suspected.