Tuberculous spondylitis or Pott disease is the most common musculoskeletal form of tuberculosis.

In the present case, the positive IGRA test for tuberculosis and the known history of a close relative with untreated respiratory tuberculosis are highly suspicious for tuberculous spondylitis.

Sometimes, however, the clinical history isn't so clear and laboratory exams are inconclusive. In such cases, it may be difficult to differentiate tuberculous vs pyogenic spondylitis.

Some findings that favor spinal tuberculosis are:

• thoracic spine location

• paravertebral abscess

• abscess walls are thin and smooth

• well-defined abscess margins postcontrast

• multiple vertebrae involved

• vertebral body destruction