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MRI Diagnosis of Tuberculous Vertebral Osteomyelitis

BELL, GORDON R., MD; STEARNS, KIM L., MD; BONUTTI, PETER M., MD; BOUMPHREY, FRANCIS R., MD

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Two patients with suspected tuberculous spondylitis and one patient with previous Pott's disease were evaluated preoperatively with magnetic resonance imaging (MRI). The MRI provided more exact anatomic localization of vertebral and paravertebral tuberculous abscesses in multiple planes not previously available with more conventional diagnostic methods in the patients with suspected tuberculous spondylitis. This was helpful for localization in planning of surgical approaches. In the patient with previous Pott's disease, spinal cord compression was detected using MRI, which showed no evidence of active tuberculosis. Two case reports are offered to show the benefit of using MRI as a diagnostic technique in preoperative evaluation and as a method of monitoring treatment response of tuberculous spondylitis. The third case shows the benefit of using MRI to rule out active infection and to detect other forms of spinal pathology.

Cleveland Clinic Foundation, Cleveland, Ohio

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