EmDocs - March 01, 2021 - By Della Porta A; Bryant J-P; Bornstein K; Montrief T
Reviewed by: Manny Singh; Alex Koyfman and Brit Long
“Take home points
- Why is spinal epidural abscess a challenging diagnosis?
- Back pain is a common chief complaint, while SEA is a rare condition.
- SEA presents with non-specific symptoms and infrequently with the classic triad.
- Diagnosis requires expensive and time-consuming imaging (MRI).
- Coexisting infections or risk factors are common in the ED setting.
How can we improve diagnostic delay of SEA?
- Implementation of decision-making algorithms can reduce time intervals of ED presentation to diagnosis.
- Statistical models have accurately discriminated cases from non-cases of SEA.
- Focused exam, such as the PVR, can detect subtle neurologic deficits and increase our assessment sensitivity.
- When indicated, early whole spine imaging can detect skip lesions and prevent delays in diagnosing multiple abscess locations.”