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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
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Maimouna S Al-Risi
MD, Specialist Radiology, Sohar Hospital, North Al Batinah,
Oman
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Article ID: 101489Z01MA2025
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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 - Substantial contributions to conception and design, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Yasser AR Selim - Substantial contributions to conception and design, Interpretation of data, Drafting the article, Final approval of the version to be published
Arwa A Al Isaii - Acquisition of data, Analysis of data, Drafting the article, Final approval of the version to be published
Noura A A lmatroushi - Acquisition of data, Analysis of data, Drafting the article, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors 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.
