BMJ Case Reports 2015; doi:10.1136/bcr-2015-211135

Idiopathic septic arthritis of a lumbar facet joint associated with paraspinal abscess

  1. Borislav Dimitrov Kitov3
  1. 1South Wight Medical Practice, Niton, Isle of Wight, UK
  2. 2Department of Clinical Radiology, Southampton General Hospital, Southampton, UK
  3. 3Department of Neurosurgery, Medical University Plovdiv, Plovdiv, Bulgaria
  1. Correspondence to Dr Margarita Borislavova Kitova-John, mimchekitova{at}
  • Accepted 28 July 2015
  • Published 13 August 2015


A 48-year-old woman presented with a 1-month history of severe lower back pain on a background of 24 h of mild fever and general tiredness with an associated right-sided foot drop. Five weeks after the onset and with no improvement in symptoms in spite of analgesia and physiotherapy, the patient had a lumbar spine MRI which demonstrated a collection extending from the facet joints of L5 and L6 to the iliacus muscle on the right. A CT-guided aspiration was performed with a lengthy hospital stay for intravenous antibiotic treatment. The culture and sensitivity study of the aspirate isolated Streptococcus pneumoniae.

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