Clinics in diagnostic imaging (123).

A 60-year-old Indian man presented with lower thoracic pain and bilateral lower limb weakness. Radiographs showed compression fractures of T8 and T9 and destruction of the T7 and T10 endplates. Magnetic resonance imaging confirmed the vertebral changes and showed subligamentous spread, paravertebral masses, and epidural involvement leading to cord compression. Computed tomography-guided biopsy showed granulomatous caseous necrosis and acid-fast bacilli, confirming the diagnosis of tuberculosis spondylitis. The imaging features of infective spondylitis, with emphasis on tuberculous spondylitis, are discussed.