BMJ Case Reports 2012; doi:10.1136/bcr-2012-007007
  • Reminder of important clinical lesson

A toddler who refused to stand or walk: lumbar spondylodiscitis

  1. Vishal Naidoo1
  1. 1BFG HS, Sennelager, Germany
  2. 2Department of Paediatrics, St Vincenz Hospital Paderborn, Paderborn, Germany
  1. Correspondence to Dr Rick van den Heuvel, rickvandenheuvel{at}


A young mother presented her 19-month-old boy to the general practitioner (GP) with a 24 h history of reluctance to stand or walk and a slightly raised temperature. The GP arranged an assessment by the paediatrician, who organised an ultrasound of the hips which was normal. Approximately 1 week later the patient became constipated as well, was seen again by another GP but no cause was found. Another week later mother consulted the initial GP again as the boy had not shown any signs of improvement and had become more irritable. The GP arranged a review by the paediatrician and MRI scans of the hips and back were performed. These scans showed normal hips but lumbar spine changes suggestive of a spondylodiscitic event. The patient was treated with intravenous antibiotics, a corset and analgesia and made an excellent recovery.

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