X ray findings of TB Spine vs Bony Metastasize

Bony metastasize

-Often involve pedicle as well as wall of vertebral body
-Lytic lesion
-No true destruction of disc space


TB Spine

-Destruction of intervetebral disc and adjacent vertebral body
-Early course there will be narrowing of disc space + erosion of adjoining surface of vertebral body.
-Later, bone destruction may lead to collapse of the vertebral body, forming the gibbus (sharp angulations)
-Paravetebral abscess may present
-Bony fusion of vertebral bodies across obliterated disc space when healing occurs.

Reference:

1.Peter Armstrong, Martin Wastie & Andrea Rockall, “Diagnostic Imaging 5th edition”, Blackwell Publishing, 2004.