Tuberculous Diskitis Osteomyelitis: A Case Report

A 37 year old Senegalese male presented with lower back and flank pain. The pain was described by the patient as both sharp and dull and sudden in onset starting one month prior to presentation, progressively worsening each day. The pain was not relieved by analgesics. The patient denied significant weight loss, subjective fever, night sweats as well as any other respiratory symptoms. No sensory or motor abnormalities were noted; however patient did report constipation for 3 weeks. The patient was referred for abdominal CT scan without intravenous contrast to evaluate for renal calculi. Significant imaging findings included diskitisosteomyelitis, possible epidural abscess, spinal cord compression, and para-aortic and paracrural lymphadenopathy. No renal calculus or hydroureteronephrosis was seen (Figure1). Shortly thereafter, an MRI of the thoracic spine without and with intravenous contrast was obtained which demonstrated findings consistent with diskitis osteomyelitis and epidural abscess causing severe spinal cord compression and flattening (Figure 2).