spinal epidural abscess: how good is our H&P?

13 Feb

Spinal epidural abscesses have variable presentations with:

  • 70-90% having back pain
  • (only) 60-70% having fever
  • 33% having point tenderness to palpation
  • 71% have an abnormal neuro exam
  • 94% of these patients have an elevated ESR

IMAGING:
–MRI spine
–CT myelogram

BOTTOM LINE:
–symptoms for epidural abscess include fever, spine tenderness, back pain
–unfortunately, less patients show up with these than you’d think (or like to think)
–MRI or CT myelogram if suspicious
–good luck

Submitted by T. Boyd.

Reference(s): Tompkins et al. Spinal Epidural Abscess. J Emerg Med. 39:3; 2010.; picture
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