crystal-induced discopathy

Spinal

disorders mimicking infection. 70-year-old male with chronic history of back pain, recently exacerbated, and inflammatory laboratory markers. Sagittal T1WI (a) shows hypointense discal changes in the L4–L5 space and epidural space (arrow). Bony erosion of endplates is also seen (black arrow) at the L5 level (b, c). Sagittal T2WI (b) shows hyperintense areas in the L4–L5 disc space (star). Contrast-enhanced sagittal and axial T1WI (c, d) show enhancement of disc space, epidural space, left facet joint, and paraspinal muscles (arrow). Non-enhancing foci correspond to crystal material (arrow). Axial and sagittal slices of CT (e, f) show in L4–L5, disc space erosions, sclerotic vertebral bodies, and confirm gout tophi in muscles (short arrow)