High F-18FDG uptake in a paraspinal textiloma

Fluorodeoxyglucose (FDG) positron emission tomography (PET) is being used increasingly to exclude chronic orthopedic infections and is especially valuable in the central skeleton for this purpose. The authors describe a 33-year-old man who underwent partial L5-S1 discectomy 3 years earlier. He was examined for increasing low back pain. To exclude underlying inflammation, FDG PET was performed. Elevated FDG uptake was noted in the right paraspinal region corresponding to the image of an abscess seen on magnetic resonance imaging. Surgery revealed a textiloma (a term given to an inflammatory mass caused by a retained textile foreign body). Microscopic examination revealed an accumulation of epitheloid histiocytes and giant cells surrounding a foreignbody material.