Presentation
Generally unwell with weight loss, night sweats and back pain.
Patient Data
There is destruction of the left side of the T12 vertebral body, and an ill-defined mass occupying the left side of the abdomen.
CT confirms destruction of the T12 vertebral body, with sclerosis of the existing bone. There is a large collection in the left retroperitoneal space, involving the psoas muscle. The appearances are of an aggressive infection.
MRI confirmed the infection to originate from the T12-L1 intervertebral disc, with an enhancing epidural abscess compressing the spinal cord, as well as the large retroperitoneal abscess - this involved the left psoas muscle and also the left erector spinae muscle. There is also a prevertebral subligamentous component. The left kidney is displaced laterally. The MRI also shows bone edema involving both the T12 and L1 vertebral bodies.
Case Discussion
The x-ray, CT and MRI appearances are typical for tuberculous spondylodiscitis, also known as Pott's disease.