The body regions covered in this clinical scenario are the cervical, thoracic, and lumbar spine. These body regions might be evaluated separately or in combination as guided by physical examination findings, patient history, and other available information. CT Spine Area of Interest CT may be used to assess the spine for suspected infection, particularly following any surgical or interventional procedure, without or with spinal implants [3,30]. When initially considering the diagnosis of spine infection, it is important to use a combination of clinical presentation in the context of these red flags, abnormal laboratory values such as elevated ESR and CRP or leukocytosis, and abnormal imaging findings [8]. In the postoperative spine, CT may show implant loosening or malpositioning as well as malalignment and imaging findings that may be caused by infection. The addition of IV contrast increases the conspicuity of paraspinal soft tissue abnormalities, such as inflammation or abscess that may be caused by infection. In those cases in which a contrast-enhanced CT is to be performed, it is not necessary or useful to perform a noncontrast-enhanced CT first, because this latter examination does not add more diagnostic information. The sensitivity and specificity of CT for spine infection is 79% and 100%, respectively, but CT has low sensitivity (6%) for the identification of epidural abscess [33]. MRI Spine Area of Interest Because of its excellent tissue characterization and anatomic delineation, MRI without and with IV contrast has a sensitivity of 96% and a specificity of 94% for the evaluation of patients with suspected spine infection [3,7,14,16,24,37,51]. MRI without and with IV contrast is often utilized for the evaluation of patients who have undergone recent spine interventions and have suspected spine infection [3,7,14,16,24,37,51]. Artifact reduction techniques are often required in patients who have spinal instrumentation. MRI also provides optimal depiction of
Suspected Spine Infection PCAs. The body regions covered in this clinical scenario are the cervical, thoracic, and lumbar spine. These body regions might be evaluated separately or in combination as guided by physical examination findings, patient history, and other available information. CT Spine Area of Interest CT may be used to assess the spine for suspected infection, particularly following any surgical or interventional procedure, without or with spinal implants [3,30]. When initially considering the diagnosis of spine infection, it is important to use a combination of clinical presentation in the context of these red flags, abnormal laboratory values such as elevated ESR and CRP or leukocytosis, and abnormal imaging findings [8]. In the postoperative spine, CT may show implant loosening or malpositioning as well as malalignment and imaging findings that may be caused by infection. The addition of IV contrast increases the conspicuity of paraspinal soft tissue abnormalities, such as inflammation or abscess that may be caused by infection. In those cases in which a contrast-enhanced CT is to be performed, it is not necessary or useful to perform a noncontrast-enhanced CT first, because this latter examination does not add more diagnostic information. The sensitivity and specificity of CT for spine infection is 79% and 100%, respectively, but CT has low sensitivity (6%) for the identification of epidural abscess [33]. MRI Spine Area of Interest Because of its excellent tissue characterization and anatomic delineation, MRI without and with IV contrast has a sensitivity of 96% and a specificity of 94% for the evaluation of patients with suspected spine infection [3,7,14,16,24,37,51]. MRI without and with IV contrast is often utilized for the evaluation of patients who have undergone recent spine interventions and have suspected spine infection [3,7,14,16,24,37,51]. Artifact reduction techniques are often required in patients who have spinal instrumentation. MRI also provides optimal depiction of