Presentation
Severe low back pain.
Patient Data
Age: 30 years
Gender: Female
From the case:
Tuberculous spondylodiscitis - lumbar spine
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The MRI sequences demonstrate:
- narrowing of L4-L5 disc space
- abnormal signal of L4 and L5 vertebral bodies which appear of low signal on T1, inhomogeneous high signal on T2 with heterogeneous enhancement on postcontrast sequences (bone marrow edema)
- Thickening with enhancement of the pre/paravertebral and anterior epidural spaces with abscess formations mainly of paravertebral location displacing the major psoas muscles laterally
- numerous small abscess formations with edematous infiltration of the quadratus lumborum muscles ad fistulous tract extending to the right gluteus maximus muscle.
Case Discussion
MRI features are most consistent with tuberculous spondylodiscitis of L4-L5 with abscess formations and fistulous tract to the right gluteal region.
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