Extensive Pott disease with large psoas muscles abscesses

Diffuse extensive bony changes are seen involving D11 through examined S2 vertebrae in the term of variable loss of height more prominent at L4 vertebra, anterior wedging, innumerable lytic lesions, end plates irregularities, and abnormal heterogeneous marrow signal eliciting intermediate to low signal intensity in T1 and intermediate to high signal in T2.

Associated disc lesions in the term of variable loss of height and abnormal signal. Most discs are seen abnormally hydrated eliciting low signal in T1 and high signal in T2 while few discs elicit low signals in T1 & T2.

Diffuse posterior sub ligamentous and epidural collections eliciting low to intermediate signal intensity in T1 and T2 partially compromising the spinal canal.

Localized anterior sub ligamentous collection is seen at the sacral region and bilateral paraspinal similar collections are also noted.

Bilateral large retroperitoneal paraspinal collections seen centered upon the psoas muscles elicit intermediate signal intensity in T1 and high signal in T2.

Multiple variable-sized retroperitoneal lymphadenopathies are also noted.  

CT study clarifies the extensive degree of vertebral bony destruction in the term of variable loss of vertebral height more prominent at L4 vertebra, anterior wedging, innumerable osteolytic destructive lesions, end plates irregularities, and abnormal heterogeneous densities.

CT study post pigtail insertion within the psoas abscesses 3 days later

Post pigtail insertion within both psoas abscesses with adequate drainage at the left side and limited at the right showing a residual large collection.

Minimal pelvic heterogenous intra-peritoneal collection with slightly thickened gut loops are incidentally seen.

Right medial cerebellar hemisphere small focal lesion is seen adjacent to the 4th ventricle measures 5mm, The lesion is mostly isointense to grey matter in T1, and presents central hypointensity in T2 surrounded by mild vasogenic edema with no associated mass effect. No diffusion restriction in DWI nor blooming in T2*.