Septic arthritis of unilateral lumbar facet joint with contiguous abscess, without prior intervention

摘要: A 40-year-old female patient presented with persistent severe back pain radiating to the right leg, abdominal and constipation. Other clinical symptoms included nausea, vomiting high-grade fever. Clinical examination showed generalised lower tenderness. There was no sensory loss or motor weakness in limbs, however investigations raised inflammatory markers. Radiographs of lumbar spine hip joint were normal. MRI revealed a septic arthritis L3/4 facet joint, associated large abscess extending anteriorly paraspinal muscles posteriorly into posterolateral aspect epidural space central spinal canal, moderate compression dural sac. Unlike any other reported similar case, this developed without prior medical intervention. The treated successfully ultrasound guided drainage joint/abscess antibiotics.