Tuberculous discitis, osteomyelitis and paravertebral abscess

Case contributed by Frank Gaillard

Presentation

Chronic cough. Now presents with back pain and paraplegia.

Patient Data

Age: 45 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Frontal and lateral chest x-rays demonstrate infiltrates in right lower lobe and right pleural effusion. A suspicious right paravertebral prominent density, not silhouetting with cardiac border, and probably a posterior mediastinal lesion. Difficult to comment on vertebrae.

Collapse and endplate destruction of mid thoracic vertebra with huge right paravertebral abscess.

Classical endplate destruction and affection og two contiguous vertebrae with paravertebral and epidural abscess, which gives cord compression.

Case Discussion

This case highlights the importance of looking for paravertebral shadows and vertebral endplates while seeing a pulmonary TB suspicion chest X-Ray. Patient is a proven case of TB osteomyelitis, discitis and paraspinal collection.

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