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Diskitis

Definition

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

Alternative Names

Disk inflammation

Causes, incidence, and risk factors

Diskitis is an uncommon condition. It is usually seen in children younger than age 10.

Diskitis can be caused by a bacterial or viral infection, or it can be caused by other inflammation, such as from autoimmune diseases (conditions in which the immune system mistakenly attacks certain cells in the body). The upper back (thoracic) and low back (lumbar) disks are most commonly affected.

Diskitis can also be confused with problems related to hip pain.

Symptoms

• Abdominal pain
• Back pain
• Difficulty getting up and standing
• Increased curvature of the back
• Irritability
• Low-grade fever (less than 102 degrees Fahrenheit)
• Recent flu-like symptoms
• Refusal to sit up, stand, or walk (younger child)
• Stiffness in back

Signs and tests

• Bone scan
• CBC
• ESR
• MRI of the spine
• X-ray of the spine

Treatment

The goal is to treat the cause of the inflammation and reduce pain. Your child may receive antibiotics if the health care provider suspects an infection. Autoimmune diseases are often treated with anti-inflammatory medications.

If the condition does not improve, steroids may be given, although an infection should be ruled out first. Pain may be relieved with painkillers (analgesics) or nonsteroidal anti-inflammatory drugs (NSAIDS). Talk to the health care provider about the best choice of medications.

Bed rest or immobilization (which may require a brace) may be recommended in some cases.

Support Groups

Expectations (prognosis)

Children with an infection should fully recover after treatment. Chronic back pain from this condition is very rare.

In cases of autoimmune disease, the outcome depends on the condition. These are often chronic illnesses.

Complications

• Persistent back pain (rare)
• Side effects of medications

Calling your health care provider

Call your health care provider if your child has persistent back pain or problems with standing and walking that seem unusual for his or her age.

Prevention

References

Cottle L, Riordan T. Infectious spondylodiscitis. J Infect. 2008;56:401-412.

Gutierrez KM. Diskitis. In: Long SS, ed. Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 82.