Case of the Month

• Severe aggressive joint associated bone lesion of the facet joints at L2-3 with possible sequestrum and gas inclusions in this region with mild associated soft tissue swelling. Most likely consistent with a septic arthritis of unclear origin. Other kind of arthritis not excluded. Previous trauma and/or underlining osteochondrosis possible. Neoplasia much less likely due to the young age of the patient. Secondary neuroforaminal stenosis at L2-3 possible. 

• Heterogeneous radiopacity of the Os penis. Differentials: Artifact due to superimposition, normal variant, aggressive bone lesion.

• Joint tap and/or fine-needle aspiration at the facet joints L2-3 to be considered. 

• Radiographic recheck in 7 to 10 days to reevaluate the possible sequestrum formation to be considered.

• No follow up was provided for this case.

Orthogonal projections of the lumbar part of the spine and of the pelvis of a skeletally immature dog in normal body condition.

Severe and aggressive joint associated osteoproliferative and osteodestructive bone lesion of the facet joints at L2-3 with diffuse permeative bone lesion with long transition zone, moderate to severe cortical destruction and moderate amorphous periosteal reaction in this region. Facet joint space not visible anymore in this region. Possible mild accumulation of gas superimposed with this region. Possible sequestrum with radiolucent involucrum in the region of the caudal articular process of L2 on the left side. Mild regional soft tissue swelling. Mild reduced visibility of the neuroforamen L2-3 secondary to superimposition with the bony changes.

Included part of the Os penis with mild heterogeneous radiopacity. 

Remaining musculoskeletal structures within normal limits. 

Included abdomen within normal limits.

Severe aggressive joint associated bone lesion of the facet joints at L2-3 with possible sequestrum and gas inclusions in this region with mild associated soft tissue swelling. Most likely consistent with a septic arthritis of unclear origin. Other kind of arthritis not excluded. Previous trauma and/or underlining osteochondrosis possible. Neoplasia much less likely due to the young age of the patient. Secondary neuroforaminal stenosis at L2-3 possible. 

Heterogeneous radiopacity of the Os penis. Differentials: Artifact due to superimposition, normal variant, aggressive bone lesion.

Joint tap and/or fine-needle aspiration at the facet joints L2-3 to be considered if clinically indicated. 

Radiographic recheck in 7 to 10 days to reevaluate the possible sequestrum formation to be considered.