CONTRIBUTION DU COUPLE TEMP/TDM DANS LE DIAGNOSTIC DâUNE SPONDYLODISCITE SURVENUE APRS ABLATION DâUN FIXATEUR DE LA CHEVILLE

Résumé

The infectious spondylodiscitis represents 2.4 / 100 000 or 2-4% of osteoarticular infections. However, its occurrence after the removal of the fixator of the ankle is a rare complication. We report a case of spondylodiscitis that occurred 10 days after the removal of the right ankle fixator and which was revealed by whole-body scintigraphy with 99 mTc-MDP and Gallium citrate 67 with bifocal fixation (spinal and right ankle). The morphological examination was completed by CT scan. This observation recalls that a distal bone entrance is possible. Imaging plays a key role in the diagnosis which is often made lately; hence the interest of some precocious modality and good hierarchical organization of explorations. As such the whole-body scintigraphy   with 99 mTc-MDP and Gallium citrate 67 is a valuable help. It has to be completed by a morphological imaging targeting the sites of hyperfixation and by a biopsy-puncture face to evocative arguments. Anyway MRI is the most sensitive and the most specific technique that allows an early positive diagnosis and a loco-regional checkup despite its limited accessibility and its multiple contra-indications that confer to the couple SPECT/CT scan all the interest.