Visitor to Australia with plain films showing L2 and L4 lesions.
MRI Lumbar Spine (selected images)
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Paraspinal and psoas soft tissue collections are present.
There are destructive lesions in the L2 and L4 vertebral bodies, with sparing of the disk spaces.
Appearances are in keeping with spinal tuberculosis.
CT guided aspiration of a paraspinal collection was positive for TB. Pott disease, also known as tuberculous spondylitis, has a typical spread described as 'sub-ligamentous': beneath the anterior longitudinal ligament, usually sparing the posterior elements and often involving multiple levels, with relative preservation of the disk spaces.