Fig 3.

A 53-year-old man with low back pain and a chilling sensation for 1 week. Sagittal T1- (A), T2- (B), and axial T2-weighted (C) MR images show T2 high-fluid signal intensity in the L5/S1 disk space with T1 low marrow signal change in the peripheral portion of the L5 lower and S1 upper bodies and paravertebral extension. As seen on anteroposterior (D) and lateral (E and F) spot radiographs, percutaneous biopsy and disk aspiration were performed at the left inferior lower body of the L5 vertebra with a left unilateral transpedicular approach under fluoroscopic guidance. Biopsy confirmed infectious spondylitis, but the causative organism was not isolated. After empiric antibiotic treatment, clinical symptoms were improved.