title: Comparison of Magnetic Resonance Imaging Findings between Pathologically Proven Cases of Atypical Tubercular Spine and Tumour Metastasis: A Retrospective Study in 40 Patients.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To note the magnetic resonance imaging (MRI) differences between pathologically proven cases of atypical spinal tuberculosis and spinal metastasis in 40 cases.
  
  
  BACKGROUND
  Spinal tuberculosis, or Pott's spine, constitutes less than 1% of all cases of tuberculosis and can be associated with a neurologic deficit. Breast, prostate and lung cancer are responsible for more than 80% of metastatic bone disease cases, and spine is the most common site of bone metastasis. Thus, early diagnosis and prompt management of these pathologies are essential in preventing various complications.
  
  
  METHODS
  We retrospectively reviewed 40 cases of atypical tuberculosis and metastasis affecting the spine from the year 2012 to 2014, with 20 cases each that were proven by histopathological examination. MR imaging was performed on 1.5 T MR-Scanner (Magnetom Avanto, Siemens) utilizing standard surface coils of spine with contrast injection. Chi-square test was used for determining the statistical significance and p-values were calculated.
  
  
  RESULTS
  The most common site of involvement was the thoracic spine, seen in 85% cases of metastasis and 65% cases of Pott's spine (p=0.144). The mean age of patients with tubercular spine was found to be 40 years and that of metastatic spine was 56 years. The following MR imaging findings showed statistical significance (p<0.05): combined vertebral body and posterior elements involvement, skip lesions, solitary lesion, intra-spinal lesions, concentric collapse, abscess formation and syrinx formation.
  
  
  CONCLUSIONS
  Tuberculosis should be considered in the differential diagnosis of various spinal lesions including metastasis, fungal spondylodiskitis, sarcoidosis and lymphoma, particularly in endemic countries. Spinal tuberculosis is considered one of the great mimickers of disease as it could present in a variety of typical and atypical patterns, so proper imaging must be performed in order to facilitate appropriate treatment.
authors: Department of Radiodiagnosis, Jawahar Lal Nehru Medical College, Aligarh Area, India.
authors: Somit
authors: S
authors: Mittal
authors: Department of Radiodiagnosis, Jawahar Lal Nehru Medical College, Aligarh Area, India.
authors: Mohd
authors: M
authors: Khalid
authors: Department of Orthopaedics, Jawahar Lal Nehru Medical College, Aligarh Area, India.
authors: Aamir Bin
authors: AB
authors: Sabir
authors: Department of Radiodiagnosis, Jawahar Lal Nehru Medical College, Aligarh Area, India.
authors: Saifullah
authors: S
authors: Khalid
keywords: Infection; Magnetic resonance imaging; Metastasis; Spine; Tuberculosis