Differential Diagnosis for Disguises from Osteomyelitis of the Spine with a Normal White Count
- Single Most Likely Diagnosis
- Degenerative Disc Disease: This condition can mimic the symptoms of osteomyelitis, such as back pain and stiffness, but is more common and often presents with a normal white blood cell count. The lack of systemic infection signs and a normal white count make this a plausible diagnosis.
- Other Likely Diagnoses
- Spinal Epidural Abscess: Although this condition can present with a normal white count, especially in early stages or in immunocompromised patients, it's a critical diagnosis to consider due to its potential for serious complications. Symptoms can include back pain, fever, and neurological deficits.
- Discitis: Infection of the intervertebral disc can present similarly to osteomyelitis but might have a more subtle onset and could have a normal white blood cell count. It's an important consideration in the differential diagnosis due to its potential for significant morbidity if not treated.
- Do Not Miss Diagnoses
- Spinal Tuberculosis: This condition can present with a wide range of symptoms, including back pain, and may have a normal white blood cell count. It's crucial to consider, especially in endemic areas or in patients with risk factors for tuberculosis, due to its potential for severe consequences if left untreated.
- Epidural Hematoma: Although not an infection, an epidural hematoma can cause severe back pain and neurological symptoms. It's a medical emergency requiring prompt diagnosis and treatment to prevent permanent neurological damage.
- Rare Diagnoses
- Chronic Recurrent Multifocal Osteomyelitis (CRMO): A rare condition that can affect any bone, including the spine, and may present with a normal white count. It's more common in children and adolescents and can be challenging to diagnose.
- Sarcoidosis Involving the Spine: Sarcoidosis is a systemic disease that can rarely involve the spine, causing back pain and other symptoms similar to osteomyelitis. A normal white count does not rule out this diagnosis, especially if other systemic symptoms are present.