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Pott disease

Case contributed by Mohammad A. ElBeialy
Diagnosis almost certain

Presentation

Back pain and mild fever for months.

Patient Data

Age: 17 years
Gender: Male
ct

Prevertebral thoracic soft tissue mass was further investigated with MRI. 

mri

A large multilocular and septated fusiform para-spinal cystic collection is seen extending from T2 to T10 vertebral bodies, it shows low T1 and high T2 and STIR signal intensity. The lesion measures roughly about 16 x 6 x 5 m in its main CC and axial diameters. The lesion causes vertebral erosions and anterior vertebral scalloping. Associated vertebral osteomyelitis is seen with extensive areas of marrow edema signal displaying low T1 and high T2 signal of the bony spine.

A small posterior intra-spinal epidural cystic lesion about 6 x 0.5 x 0.5 cm is seen indenting the cord posteriorly.

The thoracic discs are relatively spared with mild anterior T4/T5 spondylodiscitis. No posterior disc lesion. Normal size and signal intensity of the cord. Exaggerated thoracic kyphosis.

Case Discussion

The above-described findings are those of thoracic vertebral tuberculous spondylitis.

T4/T5 discitis and vertebral osteomyelitis with large multilocular and septated paraspinal abscess and smaller posterior intraspinal epidural abscess formations.

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