The classic triad of Pott's spine on X-ray (vertebral tuberculosis) consists of which three findings?

• A Pedicular erosion, posterior element involvement, and ivory vertebra
• B Disc space narrowing, adjacent vertebral end-plate erosion, and paravertebral soft tissue shadow (cold abscess) ✓
• C Lytic vertebral body lesion with periosteal reaction and skip lesions
• D Vertebral scalloping, disc calcification, and bamboo spine appearance

Explanation

The radiographic triad of Pott's spine is: (1) disc space narrowing (early — disc is avascular and susceptible to tuberculous enzymes), (2) anterior end-plate erosion of adjacent vertebrae (paradiscal involvement), and (3) paravertebral soft tissue shadow (psoas abscess or paraspinal abscess — the cold abscess). Ivory vertebra (increased density) is characteristic of lymphoma or Paget's disease. Posterior element involvement with preserved disc space is more suggestive of metastatic disease. Bamboo spine is pathognomonic of ankylosing spondylitis. The cold abscess in TB spine can track along the psoas sheath to present in the groin or thigh.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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