Dahal Prajwal, Bastola Shova, Maharjan Santosh, Adhikari Govinda, Parajuli Sabina
Consultant Radiologist, Department of Radiology and Imaging, Grande International Hospital, Kathmandu, Nepal.
Consultant Pathologist, Department of Radiology and Imaging, Grande International Hospital, Kathmandu, Nepal.
Radiol Case Rep. 2024 Aug 22;19(11):5133-5138. doi: 10.1016/j.radcr.2024.07.129. eCollection 2024 Nov.
Spinal tuberculosis usually involves intervertebral disc, pardiscal vertebra and has associated perivertebral collection. Involvement of vertebral body including the posterior element, noncontagious vertebral involvement and sparing of intervertebral discs is typical of metastasis. Index case, a 19 years old Nepali patient presented to our hospital with complaints of severe backache. Blood and urine investigations were normal except elevated erythrocyte sedimentation rate and C- reactive protein. A contrast enhanced computed tomography (CT) showed lytic lesions in clivus, C7, T10, and L3 vertebral bodies with involvement of right sided posterior elements of C7 and T10. Mild surrounding soft tissue was seen. Contrast enhanced MRI showed similar findings and also lesions in S1 and right sacral ala. Possibility of metastatic lesion was considered over tuberculosis. A CT guided biopsy from right pedicle of T10 vertebra confirmed tubercular etiology.
脊柱结核通常累及椎间盘、椎间盘旁椎体，并伴有椎旁脓肿。椎体受累包括后部结构，非传染性椎体受累且椎间盘未受累是转移瘤的典型表现。病例索引，一名19岁的尼泊尔患者因严重背痛前来我院就诊。血液和尿液检查除红细胞沉降率和C反应蛋白升高外均正常。增强计算机断层扫描（CT）显示斜坡、C7、T10和L3椎体有溶骨性病变，C7和T10右侧后部结构受累。可见轻度周围软组织。增强磁共振成像（MRI）显示了类似的结果，S1和右侧骶骨翼也有病变。考虑转移瘤的可能性大于结核。T10椎体右椎弓根的CT引导下活检证实为结核病因。
