Bone scintigraphy in tuberculous spondylodiscitis

Tuberculous affection of the spine can present in different ways, Plain rad iographs may fail to show any abnormality. Bone scintigraphy can be a very useful tool in the diagnosis and management of patients with tuberculous sp ondylodiscitis. This is a retrospective study of 40 patients in whom bone s can was performed using (TcMDP)-Tc-99m (technetium methylene diphosphonate) before starting anti-tuberculous therapy or any surgical intervention, Fou r different types of uptake were noted. The uptake was abnormal in 38 out o f 40 patients, giving a sensitivity of 95%. Multicentricity was picked up i n 25% of cases. No skull lesion was noticed in any of these patients. Rib l esions were found in six patients (ten ribs affected), The rib lesion was a lways a typical band pattern. This paper out lines the advantages as well a s limitations of bone scan in tuberculous affection of the spine.