Infection versus neoplasm in the spine: differentiation by MRI and diagnostic pitfalls
This study describes the early radiological changes which occur in infections of the spine, by examination of the initial radiographs in 45 patients with proven spinal infection. The commonest radiological change in infection of the spine was a symmetrical lesion involving the adjacent surfaces of two vertebrae, with a variable degree of reduction in height of the disc space. A paravertebral abscess was a common associated finding. No radiological pattern was completely reliable in distinguishing tuberculous from non-tuberculous infections, but in white patients the formation of new bone strongly suggested a pyogenic lesion. The presence or absence of a paravertebral abscess was not helpful in distinguishing the variety of infection.