EURORAD ESR

Case 10096

TB spondylodiscitis (Pott's Disease)

Author(s)
Mohamed, D & Bickle, IC

Palmerston North Hospital, Midcentral DHB, New Zealand.
email: diyana.mohd@hotmail.com

RIPAS Hospital, BSB, Brunei. Email:ian@bickle.co.uk
 
Patient
female, 21 year(s)
 
 
  • Figure 1
    CXR: At Presentation

    Large left sided pleural effusion with midline shift

     
    Area of Interest: Respiratory system; Imaging Technique: Digital radiography; Procedure: Education; Special Focus: Infection;
     
     
  • Figure 2
    Thoracic Spine: Discitis
     

    Irregularity of the endplates at T9/T10

     
    Area of Interest: Musculoskeletal spine; Imaging Technique: Digital radiography; Procedure: Education; Special Focus: Infection;

    Irregularity of the endplates at T9/T10

     
    Area of Interest: Musculoskeletal spine; Imaging Technique: Digital radiography; Procedure: Education; Special Focus: Infection;
     
     
  • Figure 3
    CT Chest: Basal pleural disease
     

    Basal pleural collection with enhancing thickened pleura

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Education; Special Focus: Infection;

    Bony destruction of the T10 vertebral body, with paravertebral soft tissue extension.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: CT; Procedure: Education; Special Focus: Infection;
     
     
  • Figure 4
    MRI: Thoracolumbar Spine
     

    T1 Sagittal: Low signal change within the bone marrow of T8, T9 and T10, with destructive changes at the level of the disc space.

     
    Area of Interest: Musculoskeletal spine; Imaging Technique: MR; Procedure: Education; Special Focus: Infection;

    T2 Sagittal: High signal within both the disc space and the vertebral bodies, with further soft tissue and fluid in the pre and para-vertebral spaces at this level, in keeping with a paravertebral abscess.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: MR; Procedure: Education; Special Focus: Infection;

    TIRM Sagittal: The signal change within the vertebral bodies is exquisitely shown at levels T8,T9, T10 and L4 on this sequence in keeping with multifocal infection.

     
    Area of Interest: Musculoskeletal spine; Imaging Technique: MR; Procedure: Education; Special Focus: Infection;
     
     
  • Figure 5
    MRI Thoracolumbar spine: Post Contrast

    Sagittal T1 Fat Sat, Post gadolinium: the involved vertebral bodies avidly enhance with the most profound destruction at the T9/T10 level, with a prevertebral abscess from T7-T10.

     
    Area of Interest: Musculoskeletal spine; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
Large left sided pleural effusion with midline shift
 
Irregularity of the endplates at T9/T10
 
Irregularity of the endplates at T9/T10
 
Basal pleural collection with enhancing thickened pleura
 
Bony destruction of the T10 vertebral body, with paravertebral soft tissue extension.
 
T1 Sagittal: Low signal change within the bone marrow of T8, T9 and T10, with destructive changes at the level of the disc space.
 
T2 Sagittal: High signal within both the disc space and the vertebral bodies, with further soft tissue and fluid in the pre and para-vertebral spaces at this level, in keeping with a paravertebral abscess.
 
TIRM Sagittal: The signal change within the vertebral bodies is exquisitely shown at levels T8,T9, T10 and L4 on this sequence in keeping with multifocal infection.
 
Sagittal T1 Fat Sat, Post gadolinium: the involved vertebral bodies avidly enhance with the most profound destruction at the T9/T10 level, with a prevertebral abscess from T7-T10.
 
 
 
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