Pyogenic infection of the spinal column is a relatively rare condition. Spondylodiskitis is characterized by infection of the intervertebral disk and the adjacent vertebrae. Diagnosis is often delayed because the symptoms are often nonspecific and also because of the high incidence of nonspecific low back pain in the general population. We report the case of a 42-year-old woman who developed low back pain secondary to spondylodiskitis. Her diagnosis was delayed because of a lack of supporting findings on initial magnetic resonance imaging. The case highlights the clinical scenario in which maintaining a high index of suspicion may lead to follow-up imaging and an accurate diagnosis. LEVEL OF EVIDENCE: V. CI - Copyright (c) 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.