# Unmasking the Hidden Culprit: Diagnostic Challenges in Thoracic Spinal Osteomyelitis Following COVID-19 Infection

## TL;DR

This paper discusses the challenges in diagnosing spinal osteomyelitis after a COVID-19 infection due to its nonspecific symptoms and diagnostic limitations.

## Contribution

The paper presents a rare case emphasizing the need for improved diagnostic techniques for spinal osteomyelitis.

## Key findings

- Spinal osteomyelitis can be difficult to diagnose due to nonspecific symptoms and false negatives in standard tests.
- Non-diagnostic image-guided biopsies should not rule out spinal osteomyelitis in patients with back pain.
- Further research is needed to develop better diagnostic methods for spinal osteomyelitis.

## Abstract

Spinal osteomyelitis (SO) is a rare but serious infection of the vertebrae with occasional epidural involvement. Diagnosis is complicated by nonspecific findings that oftentimes mimic malignancy or tuberculosis, with typical methods of diagnosis such as blood culture and image-guided biopsy possessing varying levels of sensitivity. In this report, we present a rare case of SO that highlights these diagnostic difficulties. SO should be considered in a patient who presents with non-specific back pain. In such cases, non-diagnostic image-guided biopsy attempts do not rule out SO. Further investigations into additional diagnostic techniques to reduce false negatives are required to limit delays in diagnosis.