A 55 year old woman with tubercular meningitis presented with low back ache of 1 week duration.
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Mri lumbosacral spine was done in axial and sagittal views.it showed an undulating thecal sac with matting of the nerve roots in the lumbar region.The nerve roots were clumped and adherent to the periphery of the thecal sac giving the appearance of Empty Thecal Sac.
Arachnoiditis especially caused due to tuberculosis is a potentially treatable cause and hence the necessity for its recognition.
Arachnoiditis of the adhesive type is albeit a rare complication of Tubercular meningitis.The exudate lies psoteriorly due to gravity and hence the adhesive nature of the nerve roots to the periphery of the thecal sac giving the appearance of Empty Thecal Sac sign.