Pleural involvement in spinal tuberculosis

Abstract

Spinal tuberculosis or Pott's disease of the spine associated with pleural involvement has long intrigued researchers regarding the nature and pathogenesis of their occurrence. We describe two interesting patients of spinal tuberculosis, one with cervical and another with thoracic spine disease, with pleural involvement, which developed after lateral extension of cold abscess involving the parietal pleura, and without any evidence of pulmonary disease.

Figure 1.

(A) Sagittal T2-weighed short tau inversion recovery image showing involvement of the sixth and seventh cervical and first thoracic vertebrae with abscess in the pre-vertebral space (arrow). Compression over the corresponding segments of the spinal cord is also evident. (B) Coronal T2- weighted short tau inversion recovery image showing circumferential involvement of the pleura (arrow heads) and prominent horizontal fissure (arrow) with a large paravertebral abscess (asterisk).

Figure 2.

(A) Sagittal T2-weighed short tau inversion recovery image showing involvement of ninth, tenth, and eleventh thoracic vertebrae with abscess in the pre-vertebral space (arrow). Compression over the corresponding segments of the spinal cord is also evident. (B) Coronal T2- weighted short tau inversion recovery image showing circumferential involvement of the pleura (arrow heads) and prominent horizontal fissure (arrow) with paravertebral abscess (asterisk). Short tau inversion recovery sequence is a sensitive technique for fluid, whether within soft tissue or bone, around joints, or along tendon sheaths (including soft tissue and marrow edema).