A32 Y man with dorsal pain from 2 y ago

 

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Doctor's Information

Name : Morteza
Family :Sanei Taheri
Affiliation : ----------------
Academic Degree: Radiologist
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Morteza Alishah

 

Patient's Information

Gender : Male
Age : 32

 

Case Section

Muskuloskeletal System

 

Clinical Summary

A32 Y man with dorsal pain from 2 y ago

 

 

Imaging Procedures and Findings

X-RAY : Decrease of posterior interval between ribs (T7-T8-T9) due to collapse of T8 spine. CT (axial) : Distortion & collapse of T8 spine body. Collection in paravertebral is seen . MRI (T1 &T2): There is para vertebral mass about of T7-T8-T9 spine that in T1W is low intensity & in T2W is high intensity . Distortion & collapse of T8 spine body with involvement of disk & compression cord due to epidural collection .

 

Discussion

TB of the spine, or Pott,s disease, causes slow collapse of one or usually more vertebral bodies, which spread underneath the longitudinal ligaments.The result is an acute kyphotic or "gibbus" deformity. This angulation, coupled with epidural granulation tissue and bony fragments, can lead to cord compression. Unlike pyogenic infections, the disks can be preserved. In late-stage spinal TB, large paraspinal abscesses without severe pain or frank pus are common, leading to the expression" cold abscess .As with other extrapulmonary TB, the chest film may be unrevealing, with the source being a primary lung lesion that is clinically silent. Unfortunately, the incidence of tuberculous spondylitis, as with other forms of TB, is on Nondegenerative Diseases of the Spine . In many parts of the developing world, TB is the most common cause of vertebral body infection, with the majority of cases seen in patients under the age of 20. TB can also affect the meninges of the spine, causing an intense pachymeningitis that enhances dramatically. Brucellosis can present as granulomatous osteomyelitis of the spine that can be difficult to distinguish from TB. Both are acid-fast bacilli, which may cause caseating granulomas.

 

Final Diagnosis

Para vertebral abscess & spondylitis of dorsal spine due to TB

 

References

Fundamentals of diagnostic radiology / [edited by] William E. Brant and Clyde A. Helms.-3rd ed. P288-289

 

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