This 29 year old IV drug abuser attended his local A & E with back pain. This was centred at the L2 level on clinical examination.

The lumbar spine films shows:
1. Loss of height of L1/L2 joint space
2. Endplate sclerosis
3. Indistinct endplates

These early changes may progress to destruction and fusion.
IV drug abusers are a classical group for discitis as bloodborne bacteria enter the vertebra and cross via small vessels into the disc.

Reference: Dahnert W. Radiology Review Manual
Credit: Dr Ian Bickle