Presentation
Three months of pain in lower thoracic spine.
Patient Data
MRI of the spine shows replacement of the normal fatty marrow throughout the T11 vertebral body and most of the posterior elements as seen best on the T1-weighted sagittal images. A small amount of abnormal soft tissue is seen adjacent to the vertebral body on the axial view. The disc spaces are uninvolved.
Case Discussion
The skeleton is the most frequent site of involvement of TB outside of the lungs and half of the cases are in the spine, particularly at the thoracolumbar junction. Adjacent vertebrae may be involved with sparing of the disc spaces. Posterior element involvement is more common than with bacterial osteomyelitis. Paravertebral soft tissue involvement may be quite prominent.