Spondylodiscitis - dorsal spine

Case contributed by Dr Ammar Haouimi

Presentation

Severe lower dorsal pain with weight loss, and night sweats.

Patient Data

Age: 65 years
Gender: Female
MRI

Loss of the T10-T11 intravertebral disc space with irregular destruction of the vertebral endplates, inferior of T10 and superior of T111 of low signal on T1, high signal on T2 with heterogeneous enhancement.

Thickening of the pre/paravertebral and anterior epidural spaces with multiple abscesses formation, extending from the anterosuperior angle of T9 to the anteroinferior angle of T11 anteriorly and from the posterosuperior angle of T10 to the posteroinferior angle of T11 posteriorly, Compression of the adjacent cord which is laminated and displaced posteriorly with an intrinsic area of T2 high signal.

Also, there is a right sacral lesion of S1 of low signal on T1, heterogeneous high signal onT2 with a relatively homogeneous enhancement on postcontrast sequences.

Case Discussion

The clinical presentation and the MRI features are suggestive of a tuberculous spondylodiscitis with multiple abscesses formation and compressive myelopathy.

The right sacral lesion is difficult to characterize on this spinal MRI exam, further imaging of the pelvis was recommended.

Note: degraded image quality of the postcontrast axial T1 fat sat due to patient motions.

 

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Case information

rID: 90151
Published: 7th Jun 2021
Last edited: 9th Jun 2021
System: Spine
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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