A Rare Cause of Acute Back Pain in a Young Adult: Case Report and Discussion of Calcific Discitis

摘要

Calcific discitis in the adult population is very rare, with fewer than 40 cases reported in the literature. Most cases thus far have involved patients presenting with mid to upper back pain of acute to subacute onset. As it is a condition that is self-resolving with rare exception, the true incidence is likely underestimated. Another factor contributing to the underestimation of individuals with back pain in general is that many patients will treat themselves before presenting for care. Back pain is one of the most common presenting symptoms to primary care physician offices and represents an economic burden of billions of dollars annually. The utilization of MRI imaging and other diagnostic work-up amount to an important component of this cost and one that could possibly be reduced with early radiological identification of this condition. We present a case in which an adult patient presented with subacute lumbar back pain, eventually diagnosed as calcific discitis. Keywords: Calcific, Discitis, CT, Back Pain, Calcium, SpineCASE REPORTA 24-year-old female with a past medical history of mononucleosis and atrial septal defect presented with an approximately one-month history of progressive back pain. She developed lower back pain after carrying heavy bags and weeding at work as a stable hand. She was evaluated in the emergency department and lumbar spine radiographs were obtained. Radiographs revealed a nonspecific area of calcification in the region of the L1-L2 intervertebral disc space with no evidence of acute fracture, subluxation, or malalignment (Figure 1). Open in a separate windowFigure 1 24-year-old female patient: Diagnosis of Calcific Discitis.Findings: Lateral radiograph of the lumbar spine demonstrates a focus of calcification at the L1-L2 intervertebral disc space (arrow).Technique: mA 518, kvp 80.