Pott disease

Case contributed by Dr Hani Salam

Presentation

60 year old female presented with vague backache.

Patient Data

Age: 60 years
Gender: Female
X-ray

Thoracic spine radiographes showed a destructive processes involving T11 associated with kyphosis of the spine which was confirmed on thoracic spine CT.

CT

Destructive processes involving T11 associated with kyphosis of the spine

MRI

Thoracic spine MRI demonstrates a kyphotic deformity involving the thoraco-lumbar region secondary to the destructive process involving the T11-12 junction. The process appears to involve the inferior aspect of the T11 and superior aspect of T12 vertebra with loss of height and evidence of paraspinal and spinal canal extension.
 
Post gadolinium demonstrates enhancement of the residual T11-12 vertebra adjacent to the disc which does not show any dominant enhancement. The anterior paraspinal extension of the process shows a cranial extension with peripheral enhancement raises the possibility of a localized abscess formation.  At this level, the spinal canal component effacing the anterior subarachnoid space and causes significant spinal cord compression with focal increased T2 signal indicating cord edema. 

Case Discussion

Thoracic spine radiographes showed a destructive processes involving T11 associated with kyphosis of the spine which was confirmed on thoracic spine CT.

Thoracic spine MRI demonstrates a kyphotic deformity involving the thoraco-lumbar region secondary to the destructive process involving the T11-12 junction. The process appears to involve the inferior aspect of the T11 and superior aspect of T12 vertebra with loss of height and evidence of paraspinal and spinal canal extension.
 
Post gadolinium demonstrates enhancement of the residual T11-12 vertebra adjacent to the disc which does not show any dominant enhancement. The anterior paraspinal extension of the process shows a cranial extension with peripheral enhancement raises the possibility of a localized abscess formation.  At this level, the spinal canal component effacing the anterior subarachnoid space and causes significant spinal cord compression with focal increased T2 signal indicating cord edema. 

Pathologically proven Mycobacterium tuberculosis infection of the thoracic spine (aka Pott disease)

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Case information

rID: 8755
Case created: 27th Feb 2010
Last edited: 10th May 2017
Inclusion in quiz mode: Included

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