Pott's Spine: Diagnostic Imaging Modalities and Technology Advancements

Area of Science:

• Orthopedics
• Infectious Diseases
• Radiology

Background:

• Spinal tuberculosis (Pott's spine) is the most common extrapulmonary form of tuberculosis.
• It accounts for 2% of all TB cases, 15% of extrapulmonary TB, and 50% of skeletal TB.
• Hematogenous spread leads to symptoms like back pain, paraplegia, and deformities.

Purpose of the Study:

• To review the diagnostic modalities for spinal tuberculosis (Pott's spine).
• To highlight the effectiveness of MRI in diagnosing spinal TB.
• To discuss recent advancements in imaging techniques.

Main Methods:

• Literature review using Google Scholar and PubMed.
• Keywords included: TB, extrapulmonary TB, skeletal TB, spinal TB, Pott's spine, Pott's paraplegia, MRI, and CT.
• Analysis of diagnostic imaging techniques for spinal TB.

Main Results:

• Plain radiographs are initial but require 30% bone loss to detect lesions.
• Computed tomography (CT) offers better bony detail than radiographs.
• Magnetic resonance imaging (MRI) is the most sensitive modality, detecting disc collapse, abscesses, and marrow edema.

Conclusions:

• MRI is the gold standard for diagnosing spinal TB due to its high sensitivity.
• Early histopathological diagnosis can be achieved through guided needle aspiration or biopsy.
• Diffusion-weighted MRI (DW-MRI) shows promise as an adjunct diagnostic tool.