Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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April 10, 2014
Tuberculous Spondylitis
- Tuberculosis and brucellosis are two common granulomatous infections of the spine.
- Tuberculosis involvement of the spine, also known as Pott disease, most often affects the lower thoracic spine.
- Patients present with fever and low back pain. Radiculopathy and myelopathy are also presenting features.
- Key Radiologic Findings: Vertebral bodies are involved with sparing of the intervening disc spaces. Infection usually spreads from one vertebral body to the adjacent vertebral body in a subligamentous manner (underneath the anterior or posterior longitudinal ligament). Anterior wedging commonly is seen of the involved vertebral body, resulting in a gibbus deformity. Occasionally, posterior elements can be involved. Pulmonary infection is seen in approximately 70% of cases.
- DDx: Brucellosis, metastasis, lymphoma
- Rx: Antituberculous treatment; surgical decompression if there is cord compression.