Case Presentation: A 69-year-old male with a significant past medical history of rheumatoid arthritis on methotrexate presented with acute-on-chronic lumbar pain. Initial imaging revealed an L3 compression fracture, with findings suggestive of discitis or osteomyelitis at L2-L3. MRI confirmed discitis/osteomyelitis, along with an epidural abscess and bilateral psoas abscesses. Further imaging also revealed cavitary pulmonary [...]