Table 3

Imaging Modality Order of Preference

Select the top ranked modality available and image the entire spine.
1. Obtain an immediate MRI with IV contrast. If this cannot be performed immediately due to contrast allergy, or if using IV contrast would delay the procedure, use next preference.
2. MRI without IV contrast. If MRI cannot be performed (eg, due to large body habitus, an implanted device, or metallic foreign body) use next preference.
3. CT myelogram. If not possible, use next preference.
4. CT with IV contrast. If osseous destruction is present on CT, re-attempt MR or myelogram/CT to evaluate the epidural space.

Note: Scintigraphy (Technetium-99 bone scan, Gallium-67 scan) and metabolic imaging (FDG CT/PET) are not considered primary imaging considerations due to low spatial resolution and specificity.

From: Vertebral Osteomyelitis, Discitis, and Spinal Epidural Abscess in Adults

Cover of Vertebral Osteomyelitis, Discitis, and Spinal Epidural Abscess in Adults
Vertebral Osteomyelitis, Discitis, and Spinal Epidural Abscess in Adults [Internet].
Chenoweth CE, Bassin BS, Mack MR, et al.
Ann Arbor (MI): Michigan Medicine University of Michigan; 2018 Dec.
© Regents of the University of Michigan.

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