胸椎に生じた化膿性椎間関節炎の1例

A case of septic arthritis of the thoracic facet joint

化膿性椎間関節炎は化膿性脊椎疾患の中で比較的まれな病態で，そのほとんどは腰椎に発症する。敗血症性肺塞栓症を伴って発症した胸椎の化膿性椎間関節炎で，脊椎後方成分の溶骨性変化をきたした症例を経験した。結晶性関節炎や転移性骨腫瘍との鑑別を要したが，MRIやCTによる病変の詳細評価が鑑別に有用であったと考える。

The patient was a male in his 30s. He was admitted to our hospital because of fever and severe back pain. Based on CT and MRI findings, septic arthritis of the Th4/5 right facet joint was suspected. As most septic facet joint arthritis cases occur in the lumbar spine, we considered a thoracic case was valuable to report. In our case, differentiation from metastatic tumor or crystal arthritis was required because CT showed osteolysis of articular processes and vertebral arch. We could diagnose it as septic arthritis by evaluating CT and MRI findings in detail.