Findings
Plain films of the spine were unremarkable except for post-operative changes. CT and bone scintigraphy showed an abnormality at T9, but could not differentiate active disease from post-op changes (arrows show attenuation from Harrington rod). Gallium-67 citrate was positive for active disease focus in the left paraspinal area at T9 which reverted to normal after surgical intervention. A loculated contained tuberculous bacillus.
Two months later the patient complained of vague low back pain. Plain films showed left SI joint destruction. CT (arrow) and Gallium-67 citrate scintigraphy (arrow) showed left psoas abscess with SI joint destruction. Results of a CT guided aspiration of the psoas abscess were positive for tuberculous bacillus.
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J. Anthony Parker, MD PhD, jap@nucmed.bih.harvard.edu
