CXR shows widened superior mediastinum with the trachea displaced anteriorly on the lateral image. Prevertebral soft-tissues are expanded: greater than one vertebral body thickness in the lower cervical spine.
CT and MR imaging shows a large septated prevertebral / paravertebral cervical and upper thoracic low density collection with enhancing wall. Destruction of multiple upper thoracic vertebrae is seen along with an epidural collection.
Features are consistent with tuberculous spondylitis (Pott disease) complicated by a large prevertebral / paravertebral abscess. Acid-fast-bacilli were subsequently confirmed.