幼児化膿性椎間板炎の1例

Juvenile Pyogenic Discitis : Case Report

　抄録：症例は2歳5カ月，女児．主訴は腰痛で立位・歩行困難．入院時の検査はWBC 10,100/μl，CRP 0.9mg/dl，ESR 62mm/hr，単純X線でL4/5椎間腔の狭小化を認め，MRI T2像で椎間板は，高・低輝度の混合像を呈し椎体終板に一部高輝度を認めた．保存的治療にて症状は軽快し，現在脊柱の変形もなく，MRIにて椎体の輝度変化は正常化傾向を示し経過は良好である．小児化膿性椎間板炎は，症状が多彩で特徴的な検査所見に乏しく早期診断が困難な場合も多い．小児の腰痛・歩行障害を診察する際には，本疾患を念頭におく必要があると考えられた．

　The patient was a 2-year-5-month-old girl with a chief complaint of low back pain and difficulty standing and walking. Laboratory studies on admission revealed a WBC count of 10,100/μl, CRP level of 0.9mg/dl, and ESR of 62mm/hr. A plain x-ray showed narrowing of the L4/5 intervertebral space. On the MRI T2 images, the intervertebral disk showed mixed high and low intensity, and vertebral body end-plate was partially high intensity. The symptoms were relieved by conservative therapy, and at present there is no spinal deformity, the changes in vertebral intensity on the MRI images are tending to become normal, and the patient's course is favorable. The manifestations of pediatric pyogenic discitis are diverse, there are few specific diagnostic test findings, and early diagnosis is often difficult. This disease must be borne in mind when examining children with low back pain and walking disorders.