Case Series


Lumbar spine facet joint septic arthritis: Two case reports

,  ,  ,  

1 MD, Specialist Radiology, Sohar Hospital, Sohar, Oman

2 MD, Consultant Radiology, Sohar Hospital, Sohar, Oman

3 MD, Radiology OMSB resident, MOH, Muscat, Oman

4 MD, Medical officer, National University, MOH, Muscat, Oman

Address correspondence to:

Maimouna S Al-Risi

MD, Specialist Radiology, Sohar Hospital, North Al Batinah,

Oman

Message to Corresponding Author


Article ID: 101489Z01MA2025

doi: 10.5348/101489Z01MA2025CS

Access full text article on other devices

Access PDF of article on other devices

How to cite this article

Al-Risi MS, Selim YAR, Al Isaii AA, Almatroushi NA. Lumbar spine facet joint septic arthritis: Two case reports. Int J Case Rep Images 2025;16(1):5–10.

ABSTRACT


Introduction: Septic arthritis of the facet joint (SAFJ) is a rare spine condition. Commonly seen in older immune-compromised patients presented with acute back pain, it needs early diagnosis and intervention.

Case Series: We report two cases presented to the emergency as acute onset low back pain with fever and high inflammatory markers. In both cases, patients were admitted and diagnosed with septic arthritis of the facet joint and associated epidural abscess. In the first case, blood cultures were sent to support the diagnosis, while in the second case ultrasound-guided aspiration was done. In both cases, cultures were positive for Methicillin-resistant Staphylococcus aureus (MRSA) and diagnosis confirmed with magnetic resonance imaging (MRI) findings. Both patients were treated with intravenous antibiotics and improved clinically.

Conclusion: This case shows the importance of thinking about septic arthritis in the facet joint in older patients who present with sudden onset back pain associated with high inflammatory markers if other differentials are excluded. Magnetic resonance imaging is considered the imaging modality of choice in the diagnosis. As well, early diagnosis and management play an important role to prevent complications.

Keywords: Facet joint, MRI, Septic arthritis

SUPPORTING INFORMATION


Author Contributions

Maimouna S Al-Risi - Conception of the work, Design of the work, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Yasser AR Selim - Conception of the work, Design of the work, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Arwa A Al Isaii - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Noura A A lmatroushi - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Guarantor of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2025 Maimouna S Al-Risi et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.