Missed T-spine osteomyelitis: the role of 18F-FDG-PET/CT in the diagnosis of vertebral osteomyelitis

Correspondence to Dr Zhaohui Liao Arter; annarter2012@gmail.com Description A 63-year-old man with a history of hyperlipidemia and Gilbert's syndrome presented to the emergency department with subjective fevers, rigours and back pain, however normal vital signs. 18-Fluoro-2-deoxyglucose positron emission tomography/CT: focal hyper-metabolism is noted within the T7 and T8 vertebral body endplates and within the intervertebral disc space demonstrating a maximum standardized uptake value of 6.5, concerning for osteomyelitis. Vertebral osteomyelitis is a severe infection of the spine and may cause significant deformity and neurologic deterioration if left untreated.2 Early and accurate detection is essential for improving the outcome.3 MRI is the most often used radiographic technique for the diagnosis of vertebral osteomyelitis and is considered very sensitive.4 However, 18F-FDG-PET/CT has an advantage in the visualisation of metastatic infection,5 in patients with bacteremia, as shown in our case.