Tuberculous Spondylodiscitis And Accompanying Bilateral Psoas Abscess, MRI Findings

Introduction: Spondylodiscitis is defined as infection of the vertebral body, intervertebral disc and posterior vertebral arch. Tuberculous spondylodiscitis may occur as a primary infection and may also occur with the activation of latent tuberculosis. In the tuberculosis spondylodiscitis, the lower thoracic and upper lumbar vertebrae are most affected, and there is often an involvement of the first lumbar spine due to infection. In this case we aimed to investigate magnetic resonance imaging (MRI) findings of tuberculous spondilodiscitis and acoompanying bilateral psoas abscess. Case: A 22-year-old male patient was admitted to the clinic with the complaint of back pain for 1 year. MRI was performed to the patient. L4, L5 and S1 vertebrae corpus destruction, bone marrow edema in these vertebrae and accompanying bilateral psoas abscess appearance were observed. Discussion:Conventional radiology has a key role in the diagnosis of musculoskeletal tuberculosis. Bone involvement with simple direct graphy can only be seen after eight weeks. Computed tomography (CT) or MRI is more specific in diagnosis. CT, MRI and bone sintigraphy are radiological methods required for early diagnosis and wide spread of infection and soft tissue involvement. Significant MRI findings for tuberculosis spondylodiscitis are the vertebral interossseous abscess and jumping lesions, subligamentous and epidural spread, broad-edged progression in the paraspinal area. Conclusion: Radiological examinations should be performed as soon as possible to avoid delay in diagnosis in spinal tuberculosis. Delayed diagnosis significantly reduces cure rates and increases complication development and morbidity.