Unveiling diagnostic challenges: A case report of noncontagious vertebral involvement in spinal tuberculosis mimicking metastasis.

Unveiling diagnostic challenges: A case report of noncontagious vertebral involvement in spinal tuberculosis mimicking metastasis.

Publication date: Nov 01, 2024

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.

Concepts Keywords
Biopsy Biopsy
Nepali Clivus
Spinal Intervertebral disc
Tuberculosis Metastasis
Urine Tuberculosis

Semantics

Type Source Name
disease MESH spinal tuberculosis
disease MESH metastasis
disease MESH backache
disease IDO blood
disease IDO protein
drug DRUGBANK Alpha-Linolenic Acid
disease MESH tuberculosis
pathway KEGG Tuberculosis
disease MESH etiology

Original Article

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