Pott's Disease (Tuberculosis of the spine)

Ray Ballinger

Straub Clinic and Hospital

rballinger at straub.net

Keywords

TB infection osteomyelitis all

History

41 y/o female with 3 months history of pain over lower thoracic spine.

Images

Midline saggital T1-weighted image

Saggital T1-weighted image through pedicle

Midline saggital T2-weighted image

Axial T1-weighted image through T11 with adjacent soft tissue abnormality on the left

Findings

MRI of the spine with and without IV contrast shows replacement of the normal fatty marrow throughout the T11 vertebral body and most of the posterior elements. A small amount of abnormal soft tissue is seen adjacent to the vertebral body. The disc space is uninvolved.

Diagnosis

Pott's Disease (Tuberculous osteomyelitis of the spine)

Discussion

The skeleton is the most frequent site of involvement of TB out side of lungs and half of the cases are in the spine, particularly at the thoracolumbar junction. Adjacent vertebra may be involved with sparing of the disc spaces. Posterior element involvement is more common than with bacterial osteomyelitis. Paravertebral soft tissue envolvement may be quite prominent.

Differential Diagnosis:

Metastatic disease
bacterial osteomyelitis.

References

1. Haaga, et al. CT and MR Imaging of the Whole Body; 4th ed.