Pyogenic spondylitis and early tuberculous spondylits in children: Differential diagnosis with standard radiographs and computed tomography

In a study of 23 patients, axial computed tomography (CT) was the most valu able modality to differentiate between early tuberculous (10 patients) and pyogenic spondylitis (13 patients). Tuberculous spondylitis showed large er osions with calcification, whereas pyogenic spondylitis showed multiple sma ll well-defined erosions, mostly without calcification. Both groups had lar ge or small paravertebral soft tissue swelling, with accompanying calcifica tion, in six of the 10 patients with tuberculous spondylitis and in only on e patient with pyogenic spondylitis. Tuberculous spondylitis showed larger intraspinal extradural abscesses, with calcification in 50% of cases, where as pyogenic spondylitis demonstrated no calcification.