Modern imaging of spinal tuberculosis

Abstract

Spinal tuberculosis (Pott disease) is uncommon in developed countries. On imaging studies diagnosis of this lesion may not be considered or it might be mistaken for pyogenic osteomyelitis. Features most strongly indicative of a diagnosis of spinal tuberculosis are relative sparing of the disc space, large paraspinous abscesses, a thick rim of enhancement around the paraspinous and intraosseous abscesses, calcifications within the paraspinous collections, and a fragmentary pattern of osseous destruction. As the disease progresses, there is worsening of the osseous destruction, leading to collapse of the vertebral body and eventual progression to kyphotic deformity. Based on recent experience, the authors review the major imaging characteristics associated with spinal tuberculosis and describe the typical course of the disease as documented on plain radiographs, computerized tomography scans, and magnetic resonance images.