A Case of Pyogenic Vertebral Osteomyelitis Involving Only the Lumbar Facet Joint

There is a historic change in clinical figure of pyogenic vertebral osteomyelitis. Especially about the location, recently the majority of pyogenic vertebral osteomyelitis involves the vertebral body and the intervertebral space and rarely involves the posterior elements. We observed a case of pyogenic vertebral osteomyelitis involving only the lumbar hemi-facet joint.Case report: a 59-year-old man presented with fever and lumbago. A month before admisson he had fever, lumbago and hematuria which had been treated by the urologist in our hospital with intravenous antibiotics. Plain radiographs of the lumbar region indicated an abnormality of the left L3-4 facet joint. A Tc-99m MDP scan indicated an increase in uptake in the left lower lumbar region. A CT scan showed destructive changes at the left L3-4 facet joint. Aspiration biopsy were negative. The patient was successfully treated with intravenous antibiotics. Follow up CT scan after a year showed osteoplastic changes at the left L3-4 facet joint.