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Review
. 2025 May 16.
doi: 10.1007/s00256-025-04943-0. Online ahead of print.

Imaging clues for the diagnosis of various pathogenic causes of infectious spondylitis

Pornrujee Hirunpat  1 , Theeraphol Panyaping  2 , Wannisa Wongpipathpong  1 , Siriporn Hirunpat  3
Affiliations
Review

Imaging clues for the diagnosis of various pathogenic causes of infectious spondylitis

Pornrujee Hirunpat et al. Skeletal Radiol. .

Abstract

Infectious spondylitis is not a common disease; however, its incidence has increased recently due to the increasing number of older patients with chronic diseases and immunocompromised status globally. The clinical presentation of infectious spondylitis may be non-specific, causing delays in diagnosis and treatment, and leading to significant sequelae. Imaging usually plays a crucial role in characterizing the presence and extent of the disease, leading to proper management, reduced mortality, and long-term neurological morbidity. Many studies have proposed imaging features to distinguish between the common causes of infectious spondylitis, pyogenic or tuberculous infections, while the less common infections, including those caused by fungi or other bacterial organisms such as brucellosis, melioidosis, and actinomycosis, are believed to lack specific imaging characteristics. In this review, we highlight the characteristic imaging findings of both common and uncommon pathogens, which can serve as key clues for accurately diagnosing various pathogenic causes of infectious spondylitis.

Keywords: CT; Imaging; Infectious spondylitis; MRI; Spondylodiscitis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Approval from the Institutional Review Board was obtained and in keeping with the policies for a retrospective review, informed consent was not required. Conflict of interest: The authors declare no competing interests.

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