Presentation
Low back pain with progressive weakness of the lower limbs, fever, weight loss, and elevated CRP.
Patient Data
The MRI sequences demonstrate a narrowing of T7-T8 disc space with a low signal T1, high signal on T2/STIR of the T7 and T8 vertebral bodies with enhancement on postcontrast sequences indicating bone marrow edema. An intradiscal abscess with peripheral enhancement is noted, extending to the neighboring endplates. Multiple abscesses formation in the pre/paravertebral spaces as well as the anterior and left posterolateral epidural space compressing the adjacent segment of the spinal cord which shows a high signal on T2/STIR (cord edema).
Case Discussion
The clinical presentation and the MRI features are most consistent with a tuberculous spondylodiscitis with multiple abscesses formation of the pre/paravertebral and epidural spaces as well as intradiscal.
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