Septic arthritis of a lumbar facet joint.

Patients occasionally present with sudden onset of back pain, deformity and fever but with radiographs which, though taken after an appropriate interval, seem to exclude sepsis in the disc or vertebral body. Since there are many synovial joints in the spine, it seemed possible that septic arthritis of a facet joint might explain the discrepancy. A search of the world literature back to 1966, however, uncovered no such cases. In one review of 201 patients with 221 suppurative arthritic joints there were no cases in which a spinal facet joint was involved (Heberling 1941); only five “small”joints were involved, most of the remainder being the knee, hip, ankle, elbow, shoulder and wrist joints in that order. Given the possibility that septic arthritis of a facet joint has not been reported before and that similar cases may go unrecognised, it seemed worthwhile to present the following case.