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Correspondence to Author: Ramy Sherif, Kathy Lyons, M J H McCarthy 

Spinal Department, University Hospital of Wales, UK.

DOI: 10.52338/aor.2024.4266

Abstract:

Background: Septic arthritis of the costovertebral joint is an extremely rare condition, often misdiagnosed due to its atypical presentation. This case report describes a unique instance of septic arthritis involving the costovertebral joint presenting as renal colic, highlighting the diagnostic challenges and management strategies.
Case Presentation: A 50-year-old Caucasian man presented with a 10-day history of non-mechanical low back pain radiating to the left flank and right buttock, accompanied by fever, weight loss, and rigors. Initial investigations revealed elevated inflammatory markers and a left lower lobe consolidation on imaging, suggestive of a respiratory tract infection. Subsequent MRI identified a right-sided L5/S1 facet joint infection, and later imaging revealed a concurrent T9/10 costovertebral joint infection. The patient was managed with long-term antibiotic therapy, which resulted in the resolution of the infection. However, the delayed diagnosis underscored the complexities of this atypical presentation.
Conclusion: Septic arthritis of the costovertebral joint can present atypically, mimicking renal or intra-abdominal pathology. Early recognition, thorough imaging, and appropriate antimicrobial therapy are crucial to prevent complications and improve outcomes. This case highlights the need for awareness of unusual presentations of spinal infections to facilitate timely diagnosis and treatment.

Citation:

Ramy Sherif . Hidden Culprit: Septic Arthritis Of The Costovertebral Joint Disguised As Renal Colic. Annals of Radiology 2024.