In spinal tuberculosis (Pott's disease), which imaging feature on MRI is most specific for tuberculosis compared to pyogenic spondylodiscitis?
- A Paravertebral abscess with a well-defined, thin-walled rim-enhancing collection at multiple levels with relative preservation of intervertebral disc initially ✓
- B Involvement of a single vertebral body only with end-plate erosion
- C Rapid disc space narrowing within 2 weeks of symptom onset
- D Posterior element involvement as the predominant finding
Correct answer: A. Paravertebral abscess with a well-defined, thin-walled rim-enhancing collection at multiple levels with relative preservation of intervertebral disc initially
Explanation
Spinal TB characteristically spares the disc space early (unlike pyogenic spondylodiscitis, which attacks the disc and adjacent end plates rapidly). MRI features more specific to TB include subligamentous spread of abscess spanning multiple levels beneath the anterior longitudinal ligament, well-defined paravertebral collections with rim enhancement (cold abscess), skip lesions, and relative disc preservation early in disease. Rapid disc destruction and single-level monovertebral involvement are more typical of pyogenic infection.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.