Pott disease

Diagnosis almost certain

Presentation

Fever, neck rigidity and dysphagia of 2 weeks duration. The patient had night sweats and fever, a productive cough and dyspnea over the past 2 years.

Patient Data

Age: 30-35 years old

Gender: Female

From the case: Pott disease

MRI

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Sagittal T1

Complete collapse of C7 vertebra with a resultant vertebral plana and localized gibbus deformity. Associated loss of C6-7 disc and prevertebral fluid collection with enhancing margin are noted suggesting a prevertebral abscess. C6 vertebra shows extensive marrow edema.

Diagnosis: Tuberculous spondylodiscitis (Pott's disease)

Case Discussion

The patient is known to have pulmonary tuberculosis. Spinal affection occurs via hematogenous route and it usually starts within the vertebral body. Infection may spread under the anterior longitudinal ligament and ascend/descend to involve other distant vertebrae. Differential considerations include pyogenic spondylodiscitis and brucellosis.