Clinics in diagnostic imaging (123)

Wong SBS, Peh WCG, Lim SL
Correspondence: Prof Wilfred CG Peh, wilfred@pehfamily.per.sg

ABSTRACT
A 60-year-old Indian man presented with lower thoracic pain and bilateral lower limb weakness. Radiographs showed compression fractures of T8 and T9 and destruction of the T7 and T10 end-plates. Magnetic resonance imaging confirmed the vertebral changes and showed subligamentous spread, paravertebral masses, and epidural involvement leading to cord compression. Computed tomography-guided biopsy showed granulomatous caseous necrosis and acid-fast bacilli, confirming the diagnosis of tuberculosis spondylitis. The imaging features of infective spondylitis, with emphasis on tuberculous spondylitis, are discussed.

Keywords: infective spondylitis, pyogenic spondylitis, tuberculosis, tuberculous spondylitis, vertebral infection
Singapore Med J 2008; 49(7): 581-591