title: Tuberculosis of the spine on Tc-99m MDP bone scan: additional role of SPECT-CT.
abstract: Dedicated multislice single-photon emission computed tomography-computed tomography (SPECT-CT) is useful for accurate anatomic localization and lesion characterization of abnormal findings on planar scintigraphy. We present a case of a 33-year-old woman with a history of low back pain. Lumbar spine radiographs demonstrated irregularity of the superior end plate of L2 with an associated compression fracture. A Tc-99m MDP bone scan was performed given her young age and the absence of a history of trauma. The whole body planar imaging revealed nonspecific findings of diffuse linear increased tracer uptake involving L2. The SPECT-CT findings were in keeping with spinal tuberculosis. This was confirmed with culture of CT-guided aspiration of a left psoas collection, which revealed heavy growth of Mycobacterium tuberculosis. This case highlights the benefits of multislice SPECT-CT imaging in the anatomic localization of increased metabolic activity and provision of additional diagnostic information. This enabled rapid diagnosis and management.
authors.affiliation: Department of Nuclear Medicine, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom. gopinath.gnanasegaran@gstt.nhs.uk
authors.forename: Gopinath
authors.initials: G
authors.lastname: Gnanasegaran
authors.forename: Tara
authors.initials: T
authors.lastname: Barwick
authors.forename: Heather
authors.initials: H
authors.lastname: Milburn
authors.forename: Sanjay
authors.initials: S
authors.lastname: Vijayanathan
authors.forename: Ignac
authors.initials: I
authors.lastname: Fogelman
mesh_terms: D000328:Adult; D005260:Female; D050815:Fractures, Compression / Q000209:etiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D009169:Mycobacterium tuberculosis; D019275:Radiopharmaceuticals; D016103:Spinal Fractures / Q000209:etiology; D013669:Technetium Tc 99m Medronate; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D014399:Tuberculosis, Spinal / Q000150:complications / Q000000981:diagnostic imaging*; D051598:Whole Body Imaging
chemical_list: D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate