Presentation
Known history of tuberculosis. Back pain. Increased indicators of inflammation.
Patient Data
Large psoas collection with marginal enhancement.
Focal of increased T2 and low T1 signal in the bodies of L3, L4 and L5 vertebrae with enhancement after IV contrast administration.
Increased T2 signal of the intervertebral disc at L3-L4. Destruction of the disc at L4-L5.
The presence of multiple peripherally enhanced foci of different sizes, increased T2 signal (abscesses) in the body of the L4 and L5 vertebrae, in the sacrum and the coccyx, in the L4-L5 intervertebral space and the paravertebral soft tissues at the level of the L4, L5 vertebrae and around the sacrum with extension and into the medullary canal at the level of I1 and below. Pressure effects on the descending and ascending roots of cauda equina.
Lytic lesions in the bodies of L3, L4, L5 and the sacrum. Disturbance of the architecture of the upper endplate of the S1 vertebra with subsidence of the body of S1 vertebra.
Case Discussion
Tuberculous spondylitis, also known as Pott disease, with paravertebral abscess formation extending into the medullary canal and bilateral psoas muscles. Destruction of the vertebral bodies and intervertebral discs.
CT-guided psoas abscess drainage was done.