Septic facet joint arthritis

Mechanism and manifestations

Focal spinal pain and sometimes fever may occur. Symptoms can resemble mechanical facet pain, but progression, risk factors and systemic signs alter suspicion.

Diagnosis and management

MRI and blood cultures are often useful, and sampling may be needed. Antibiotics and sometimes drainage treat the infection. Deficit or sepsis signs require emergency care; injection, manipulation and traction should be deferred.

Points to consider

Infection and inflammatory disease require different treatments. Fever, immunosuppression, infection history, unusual pain and neurological deficits influence urgency. Absence of fever does not exclude infection. Physical modalities must not delay necessary medical investigation.

Role of TAGMED care

With acute symptoms, urgent hospital assessment takes priority. This condition first requires medical diagnosis and, depending on the situation, specialist management. TAGMED services do not replace treatment of infection or tumor, stabilization of an unstable injury, or neurological or vascular treatment. Any conservative support should be considered only after diagnosis, restrictions and the treating team’s recommendations have been clarified.

Related concepts and distinctions

These concepts belong to the same field, but are not synonyms.

• Spinal tuberculosis — Spinal infection caused by Mycobacterium tuberculosis, potentially destroying vertebrae and causing abscess, deformity or neurological compression.
• Cervical involvement in rheumatoid arthritis — Inflammatory cervical joint and ligament involvement in rheumatoid arthritis, potentially causing atlantoaxial instability among other changes.
• Vertebral osteomyelitis — Infection of vertebral bone, often associated in adults with adjacent disc and endplate involvement.

Medical references

1. Infectious Diseases Society of America. Native Vertebral Osteomyelitis in Adults: Clinical Practice Guidelines.
2. American College of Radiology / RSNA, RadiologyInfo. Spine MRI.

References document the topic; their inclusion does not imply endorsement of TAGMED services by those organizations.