Significance of repeat magnetic resonance imaging in diagnosing vertebral osteomyelitis

Vertebral osteomyelitis can result in serious complications if diagnosis is delayed. Magnetic resonance imaging ( MRI ) is considered the most useful modality for the early diagnosis of vertebral osteomyelitis. We examined three patients with vertebral osteomyelitis whose initial MRI (obtained <2 weeks after the onset of symptoms) did not reveal obvious findings of pyogenic vertebral osteomyelitis. However, follow‐up MRI clearly demonstrated typical findings of the disease. This case series illustrates that a repeat MRI must be performed 2‐4 weeks after the onset of symptoms in patients presenting with clinical manifestations and microbiological findings suggestive of vertebral osteomyelitis.