MULTIPLE VERTEBRAL BODY DESTRUCTION ON MULTIPLE VERTEBRAL REGION IN A CASE OF PEDIATRIC TUBERCULOUS SPONDYLITIS Fahmi Hasan, Fifi Sofiah,

Yangtjik K.,Faisal RM*. Department of Child Health, Department of Radiology*, Faculty of Medicine Sriwijaya University, Dr. Mohammad Hoesin Hospital, Palembang Abstract Background Tuberculous Spondylitis most often found in the lower thoracic and upper lumbar regions, while cervical tuberculous spondylitis (cervical tuberculosis) is an uncommon disease (only 23%). Recognition and understanding of the radiological findings may help in diagnosis. The distinct patterns of spinal tuberculosis may be seen: the classic finding of spondylitis,characterized by destruction of two or more contiguous vertebrae and opposed end plates, disk infection, and commonly a paraspinal mass or collection. Objective To report a rare case of radiology imaging of multiple body destruction of tuberculous spondylitis in a child. Case An8-year-old girl admitted to Mohammad Hoesin Hospital presenting with chronic low back pain and paraparesis of the lower limbs. Physical examination revealed loss of body weight, mild fever. Erythrocyte Sedimentation Rate increased at 120 mm/h. A tuberculin skin test was positive (22 mm), and no acid fast bacille found from sputum smear. Plain radiography showed C1-C3,T4-T6,T10,L4-5 spondylitis,T4,T5 paraspinal abscess. Computed Tomography showed bone destruction centrally and anterior located in the spinal body of T5. Thoraco-lumbar imaging shows paraspinal abscess in T4 and T5. Patient showed clinical improvement after one month therapy of anti tuberculostatic agents and collar breast holder. Conclusion The distinct patterns of spinal tuberculosis in this patient with destruction of two or more contiguous vertebrae located in the spinal body from C1 until L5and paraspinal abscess emphasized the value of radiology imaging in the diagnostic workup of this rare type of spinal tuberculosis. Keywords: Tuberculous spondylitis, cervicalis vertebrae, radiology imaging