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

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