Copyright (c) 2026 Beatriz Ruiz Vass, Diego Ortiz, Rolando Reyna
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
A 47-year-old male with no known medical history underwent contrast-enhanced lumbar spine MRI, which revealed L3-L4 spondylodiscitis with vertebral endplate erosion, intraosseous abscesses, anterior epidural abscess, and bilateral psoas muscle involvement. Preservation of the anterior meningovertebral ligament was identified within the epidural collection, with moderate compression of the cauda equina nerve roots. The MRI pattern was highly suggestive of tuberculous etiology based on the combination of well-defined paravertebral collections in the psoas muscles, intraosseous abscesses, and epidural spread, guiding the clinical diagnosis and management prior to definitive microbiological confirmation. MRI findings useful for differentiating spinal tuberculosis from pyogenic spondylodiscitis are discussed, as well as the importance of image-guided biopsy for microbiological confirmation.
