Tuberculous spondylodiscitis (Pott disease)

Case contributed by Dr Ian Bickle

Presentation

This 30 year-old male patient presented with leg weakness.

Patient Data

Age: 30
Gender: Male
Modality: X-ray

Destruction of T12 and L1, with a resultant gibbus.  The destructive process is centred on the T12/L1 disc space.

Images courtesy of Dr Selvam (Neurosurgeon, RIPAS Hospital, Brunei).

Modality: MRI

T12/L1 spondylodiscitis - with avid contrast enhancemen involving the T11-L2 vertebral bodies, T12/L1 disc space and the adjacent paravertebral collections.

Plethora of collections as a consequence of the spondylodiscitis are evident  - the so called 'cold abscesses' of TB, with intense ring enhancement.

Case Discussion

This case demonstrates a rather extreme example of tuberculous spondylodiscitis.
A gibbus deformity has occurred secondary to a severe T12/L1 spondylodiscitis, with impingement of the spinal cord, just proximal to the conus.

The following collections are present :

 

  1. Bilateral psoas
  2. Anterior and posterior vertebral (subligamentous)
  3. Deep subcutaneous
  4. Erector spinae and quadratus lumborum
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Case Information

rID: 25134
Case created: 7th Oct 2013
Last edited: 1st Mar 2016
Inclusion in quiz mode: Included

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