SIGNIFICANCE OF MAGNETIC RESONANCE IMAGING FINDINGS IN POTT’S DISEASE. A DESCRIPTIVE CASE SERIES

Abstract

Objective: To describe characteristic Magnetic Resonance Imaging features and assess the significance of this imaging in spinal tuberculosis (Pott’s disease).

Study Design: Descriptive study.

Place & Duration of study: Combined Military Hospital, Rawalpindi, from Jun 2017 to Jul 2018.

Methodology: This study was carried out at the Department of Orthopedic Surgery at Combined Military Hospital, Rawalpindi from Jun, 2017 to Jul, 2018. A total of 120 consenting adults who were diagnosed cases of Pott’s disease were selected for the study. There were 60 males (50%) and 60 females (50%). Age range was 20-60 years. Mean age was 40 years. Diagnosed cases of spinal tuberculosis based on clinical, pathological and radiological findings were included in the study. Cases of pyogenic spondylitis, pyogenic psoas abscess, spinal trauma and vertebral column tumors were excluded.

Results: Magnetic Resonance Imaging scan showed that lower thoracolumbar (49.1%) was the most common involved level. Only involvement of thoracic spine was found in 25 cases (20.8%). Lumbar spine was involved in 23 cases (19.1%). Cervical spine was involved in 9 cases (7.5%). Diffuse involvement of spine was found in only 4 cases (3.3%). Magnetic Resonance Imaging features and their incidences were: disc space narrowing/destruction in 105 (87.5%) cases, complete body destruction in 25 cases (20.8%), wedge collapse of body in 28 cases (23.3%), paraspinal abscess in 67 cases (55.8%), compression of spinal cord in 30 cases (25%) and calcification in 22 cases (18.33%).

Conclusion: The significance of Magnetic Resonance Imaging is enormous in patients with spinal tuberculosis. It provides accurate information about the involvement of vertebrae, spinal cord and paraspinal soft tissues. This imagimg proved to be very advantageous from clinical as well as management point of view as serial scans describe the progression or regression of disease with great precision.