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Severe Pott disease with multiple muscular and subcutaneous abscesses

Case contributed by Michael P Hartung
Diagnosis almost certain

Presentation

Back pain and palpable masses.

Patient Data

Age: 20 years
Gender: Female

L1/L2 disk loss with endplate erosions and sclerosis and mild focal kyphosis. Collections (some of which are partially calcified) in the paraspinal region of lower thorax, right psoas muscle which decompresses into the posterior right flank subcutaneous tissues through a thin tract resulting in a very large collection, left psoas and iliacus muscles with extension into the left presacral space resulting is osteomyelitis. Mild bilateral striated nephrograms. 

Case Discussion

Dramatic presentation of advanced Pott disease with characteristic cold abscess with partial calcifications involving the subligamentous, muscular and subcutaneous distributions and with left sacral osteomyelitis. 

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