A Pott diagnosis

This is spinal tuberculosis on a midline T2 weighted sagittal magnetic resonance image of the spine of a woman in her 20s (fig 1). She had experienced intermittent, dull low back pain for two years, with night sweats and fatigue but no fever, loss of appetite, or weight loss. She had no symptoms of spinal cord compression. Blood tests showed anaemia (haemoglobin 100 g/L, normal range 110-150 g/L), and tuberculosis was diagnosed based on positive acid fast bacilli staining of sputum, tuberculin skin test, interferon gamma release assay (T SPOT test), and Mycobacterium tuberculosis blood culture. Appearances on MRI were characteristic of spinal tuberculosis, including paravertebral abscesses with bone destruction, disc space narrowing, kyphosis, and spinal cord compression at T11-L1. An MRI is useful to differentiate spinal tuberculosis from non-tubercular lesions in people presenting with lower back pain and systemic symptoms.1bmj;381/jun01_4/e073764/F1F1f1Fig 1
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