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Tuberculous spondylodiscitis (Pott disease)

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Leg weakness.

Patient Data

Age: 30 years
Gender: Male

Destruction of T12 and L1, with a resultant gibbus.  The destructive process is centered on the T12/L1 disc space.

Images courtesy of Dr. Selvam (Neurosurgeon, RIPAS Hospital, Brunei).

T12/L1 spondylodiscitis - with avid contrast enhancement involving the T11-L2 vertebral bodies, T12/L1 disc space, and the adjacent paravertebral collections.

A plethora of collections as a consequence of spondylodiscitis are evident  - the so-called 'cold abscesses' of TB, with intense ring enhancement.

Case Discussion

This case demonstrates a rather extreme example of tuberculous spondylodiscitis.
A gibbus deformity has occurred secondary to a severe T12/L1 spondylodiscitis, with impingement of the spinal cord, just proximal to the conus.

The following collections are present : 

  1. bilateral psoas

  2. anterior and posterior vertebral (subligamentous)

  3. deep subcutaneous

  4. erector spinae and quadratus lumborum

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