Spinal Tuberculosis Resembling Neoplastic Lesions on MRI

Area of Science:

• Radiology
• Orthopedics
• Infectious Diseases

Background:

• Tuberculous spondylitis is a common cause of skeletal tuberculosis in developing nations, leading to significant morbidity from spinal cord compression.
• Early diagnosis and intervention are vital to prevent permanent spinal deformity and neurological deficits.

Purpose of the Study:

• To highlight atypical MRI findings in tuberculous spondylitis that resemble neoplastic lesions.
• To emphasize the importance of considering tuberculous spondylitis in the differential diagnosis of spinal pathologies, particularly in endemic regions.

Main Methods:

• Prospective study of 59 patients with tuberculous spondylitis exhibiting atypical MRI features suggestive of neoplasm.
• Diagnosis confirmed via cytology, histopathology, and serology.
• MR imaging performed on a 0.2 T Siemens MRI scanner between June 2011 and December 2014.

Main Results:

• Lumbosacral involvement was most common (30.5%), followed by dorsal and cervical regions.
• No intervetebral disc involvement was observed in 100% of cases.
• Posterior appendage involvement occurred in 54.2%, with soft tissue components in intraspinal (37.2%) and paraspinal (45.7%) areas. Cord compression was noted in 32.2%.

Conclusions:

• Tuberculous spondylitis can present with diverse imaging appearances on MRI.
• Consider tuberculous etiology for spinal and paraspinal lesions, alongside other differentials.
• Prompt diagnosis facilitates timely treatment, reducing morbidity and complications.