Imaging and differential diagnosis of pediatric spinal tuberculosis

ObjectiveThis paper aimed to summarize imaging features of pediatric spinal tuberculosis.MethodsThe spinal X-ray, CT and MR presentations of 21 patients under 18 years old who were confirmed with tuberculosis by biopsy or pathological surgery were retrospectively analyzed.ResultsAmong the 21 cases, 14 cases (66.7%) had consecutive multi-vertebral lesions; 2 cases (9.5%) had nonconsecutive multi-vertebral lesions; and 5 cases (23.8%) had single vertebral lesion. Besides, 18 (85.7%) cases presented with typical imaging findings: well-defined bone destruction, intervertebral space stenosis and existence of marginal sclerosis, sequestrum and paravertebral soft tissue. The remaining 3 (14.3%) cases presented with atypical imaging findings, with two cases of single vertebral lesion misdiagnosed as Langerhans cell histiocytosis and one case of nonconsecutive multiple vertebral lesions and ill-defined bone destruction diagnosed as malignant neoplasm.ConclusionPediatric spinal tuberculosis often occurs in the cervical and thoracic vertebrae with typical imaging findings. The cases with atypical manifestations should be differentiated from other diseases such as Langerhans cell histiocytosis and metastatic neoplasm.