Figure 28.

Tuberculous spondylodiscitis – sagittal T1W post-contrast fat-suppressed (A) magnetic resonance (MR) image of the lumbar spine demonstrates osteomyelitis of the L2 vertebral body with partial collapse of the superior endplate and extensive adjacent epidural phlegmon (white arrowheads) in this patient with spinal tuberculosis. The adjacent intervertebral discs do not exhibit inflammatory changes (white arrows), a finding more frequently encountered in spinal tuberculosis as opposed to pyogenic spondylodiscitis. Axial T1W post-contrast fat-suppressed (B) MR image through the L2 vertebra shows a well-defined rim-en- hancing collection extending into the right psoas muscle without significant adjacent inflammatory changes consistent with cold abscess (black arrow). Sagittal short-tau inversion recovery (C) MR image of the thoracolumbar spine in a different patient demonstrates multilevel severe anterior wedge compression deform- ities of the thoracolumbar junction with resultant severe focal kyphosis compatible with gibbus deformity in this patient with history of prior spinal tuberculosis