Bone scintigraphy in tuberculous spondylodiscitis

Tuberculous affection of the spine can present in different ways. Plain radiographs may fail to show any abnormality. Bone scintigraphy can be a very useful tool in the diagnosis and management of patients with tuberculous spondylodiscitis. This is a retrospective study of 40 patients in whom bone scan was performed using 99mTc-MDP (technetium methylene diphosphonate) before starting anti-tuberculous therapy or any surgical intervention. Four different types of uptake were noted. The uptake was abnormal in 38 out of 40 patients, giving a sensitivity of 95%. Multicentricity was picked up in 25% of cases. No skull lesion was noticed in any of these patients. Rib lesions were found in six patients (ten ribs affected). The rib lesion was always a typical band pattern. This paper outlines the advantages as well as limitations of bone scan in tuberculous affection of the spine.