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Diskitis

Skeletal spineSkeletal spine
Intervertebral disIntervertebral disk

Disk inflammation

Definition

Diskitis is swelling (inflammation) and irritation of the space between the bones of the spine (intervertebral disk space).

Causes

Diskitis is an uncommon condition. It is usually seen in children younger than 10 years and in adults around 50 years of age. Men are more affected than women.

Diskitis can be caused by an infection from bacteria or a virus. It can also be caused by inflammation, such as from autoimmune diseases. Autoimmune diseases are conditions in which the immune system mistakenly attacks certain cells in the body.

Disks in the neck and low back are most commonly affected.

Symptoms

Symptoms may include any of the following:

Abdominal pain
Back pain
Difficulty getting up and standing
Fever (typically 102°F or 38.9°C or lower)
Increased curvature of the back
Irritability
Neck pain
Sweating at night
Recent flu-like symptoms
Refusal to sit up, stand, or walk (younger child)
Stiffness in back

Exams and Tests

The health care provider will perform a physical exam and ask about the symptoms.

Tests that may be ordered include any of the following:

Bone scan
Complete blood count (CBC)
ESR or C-reactive protein to measure inflammation
MRI of the spine
X-ray of the spine

Treatment

The goal is to treat the cause of the inflammation or infection and reduce pain. Treatment may involve any of the following:

Antibiotics if the infection is caused by bacteria
Anti-inflammatory medicines if the cause is an autoimmune disease
Pain medicines such as NSAIDs
Bed rest or a brace to keep the back from moving
Surgery if other methods don't work

Outlook (Prognosis)

Children with an infection should fully recover after treatment. In rare cases, chronic back pain persists.

In cases of autoimmune disease, the outcome depends on the underlying condition. These are often chronic illnesses that need long-term medical care.

Possible Complications

Complications may include:

Persistent back pain (rare)
Side effects of medicines
Worsening pain with numbness and weakness in your limbs

When to Contact a Medical Professional

Contact your provider if you or your child has back pain that does not go away, or problems with standing and walking that seem unusual for the child's age.

References

Mathew R, Hong DK. Diskitis. In: Long SS, Prober CG, Fischer M, Kimberlin DW, eds. Principles and Practice of Pediatric Infectious Diseases. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 77.

Williams KD. Infections and tumors of the spine. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 42.

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Review Date: 9/20/2022

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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