Brought to you by
ECR 2018 / C-2238
Commonest locations of challenging TB bug in spine
Congress: ECR 2018
Poster No.: C-2238
Type: Educational Exhibit
Keywords: Infection, Education, MR, Musculoskeletal system, Musculoskeletal spine
Authors: S. Arooj1, M. farooq1, S. Kadri2, K. Qadir3; 1Karachi/PK, 2Karachi, karachi/PK, 3Karachi, Si/PK
DOI:10.1594/ecr2018/C-2238

Findings and procedure details

After ethical review committee approval, we conducted this cross sectional study at Radiology department of JPMC from july to december 2016. Out of a total of 2995 MRI of spine, 51 cases were found to have TB of spine; confirmed on histopathology.

The scanning was performed on 1.5T Achieva Nova Philips scanner and 0.3T Hitachi(open scanner).

The patients included in the study had a backache of three months duration. Their MR features included involvement of endplates and vertebral bodies along with prevertebral, epidural and paraspinal collections.

The patients who had TB and were on treatment, post traumatic, post surgical, metastatic and degenrative spines were excluded from the study. The patients whose histopathology was not available were also excluded.

A neuroradiologist with a postfellowship experience of five years read the scans. 

Few of the cases with tuberculous spine/ Pott's disease are shared below:-

Case 1:

Fig. 1: 57 years old male with backache. Intraosseous tb abscesses are seen in lower dorsal vertebrae with peripheral thick enhancing walls seen on T1W post gadolinium images
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 2: 57 years old male with backache. Re demonstration of intra osseous TB abscesses are seen in lower dorsal vertebrae with peripheral thick enhancing walls seen on T1W post gadolinium images. There is anteriot thecal meningeal enhancement as well.
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 3: Same patient. Lower dorsal vertebral bodies show compression/ collapse with involvement of intervening IV disc, epidural component causing cord compression and edema.
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 4: Same patient, similar T2WI findings as mentioned in fig.3
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 5: Same patient, Marrow replacement lower dorsal vertebrae, hypointense on T1WI. Rest of the vertebrae appear unremarkable.
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK

 

 

Case 2:

 

Fig. 6: Case 2. 23 years old male with history of fall two years back. complains of fever and backache for one month. Compression of D12/L1 vertebrae with angulation deformity and involvement of intervening IV disc. Another abnormally enhancing area superior endplate of L4.(T1WI)
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 7: Case 2. 23 years old male with history of fall two years back. complains of fever and backache for one month. Compression of D12/L1 vertebrae with angulation deformity and involvement of intervening IV disc. Another abnormally enhancing area superior endplate of L4.
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 8: Same patient, post contrast coronal T1WI show oblique right paravertebral components with enhancing walls as well.
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 9: Same patient, post contrast T1WI show enhancement of endplates with intraosseous absesses showing peripheral enhancing walls. There are prevertebral components as well.
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 10: Same patient, post contrast axial T1WI show right paravertebral components with enhancing walls as well.
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK

 

Case 3:

Fig. 11: 26 year old female with bilateral lower limb weakness. T2WI show compression/ collapse of lower dorsal vertebral bodies causing retropulsion in the spinal canal resulting in conal compression
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 12: 26 year old female with bilateral lower limb weakness. T2WI show compression/ collapse of lower dorsal vertebral bodies causing retropulsion in the spinal canal resulting in conal compression
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 13: 26 year old female with bilateral lower limb weakness. Post contrast sagittal T1WI show compression/ collapse with enhancement of lower dorsal vertebral bodies causing retropulsion in the spinal canal resulting in conal compression
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 14: 26 year old female with bilateral lower limb weakness. Coonal T1WI show compression/ collapse of lower dorsal vertebral bodies with bilateral paravertebral components
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK

 

 

Case 4:

 

 

Fig. 15: T1W hypointense marrow signals with involvement of multiple vertebral bodies in a 15 year old female
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 16: T2W axial images show bilateral paravertebral abscesses, hyperintense on T2W images in a 15 year old female
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 17: T2W hyperintense paravertebral components in a 15 year old female
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 18: T2W hyperintense marrow signals with involvement of multiple vertebral bodies and intervening intervertebral discs in a 15 year old female
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK

Case 5:

 

Fig. 19: 40 years old labourer with low grade fever and backache.Hypointense L2 vertebral body with involvement of enfacing endplates and epidural components
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
Fig. 20: 40 years old labourer with low grade fever and backache.Hyperintense L2 vertebral body with involvement of enfacing endplates and epidural components
References: Jinnah post graduate medical centre , Jinnah post graduate medical centre - Karachi/PK
POSTER ACTIONS Add bookmark Contact presenter Send to a friend Download pdf
SHARE THIS POSTER
2 clicks for more privacy: On the first click the button will be activated and you can then share the poster with a second click.

This website uses cookies. Learn more