Man with Debilitating Back Pain

ANSWER
The radiograph demonstrates generalized degenerative changes. Of note are fairly significant destructive changes in the endplate at the L3-4 level. Such changes are generally consistent with osteomyelitis and diskitis.

On further questioning, the patient reported that when he was admitted previously, he was told that he had an “infection in his back” and was treated with IV antibiotics. This patient was again admitted for additional workup and treatment.