Radiological Case: Hardware Infection

Thomas R. Capobres, MD; Ishani Dalal, MD


Appl Radiol. 2018;47(7):40-41. 

In This Article

Case Summary

A 70-year-old man underwent a T9-T10 facetectomy with instrumented back fusion. Postoperatively, he developed a bowel obstruction and was found to have a rectal squamous cell carcinoma. Emergency resection was performed followed by chemoradiation.

A follow-up PET/CT was obtained 4 months' status post-resection, which demonstrated suspicious uptake around the thoracic spine hardware. The ordering physician was notified of a potential hardware infection, but at that time, the patient was asymptomatic and had been recently seen in clinic without any evidence to suggest infection. Within 1 week following the PET/CT, the patient presented with a new abscess and drainage from his incision site. Erythrocyte sedimentation rate and C-reactive protein were both elevated. Cultures from the abscess grew methicillin-resistant Staphylococcus aureus. The patient was taken back to the OR for debridement and hardware removal. He eventually made a full recovery after a prolonged course of antibiotics.