Imaging of Pyogenic Epidural Abscess

Spinal epidural abscess is an uncommon but severe infection affecting the spinal canal with the potential for causing serious complications such as spinal cord compression and infarct with resultant paralysis, if treatment is delayed. Despite advances in medical knowledge and imaging techniques, it is often misdiagnosed at initial presentation due to its insidious onset and nonspecific clinical signs. The classical triad of spinal pain, fever, and neurological deficit is often not present at initial presentation, making the diagnosis based on clinical findings alone challenging. Imaging thus plays a crucial role in the evaluation and early detection of this condition, allowing for prompt treatment to improve prognosis and clinical outcome. This chapter serves to describe the use of various techniques available for imaging pyogenic abscesses in spinal infections, particularly magnetic resonance imaging which is the modality of choice for diagnosis.