This article presents a detailed review of imaging modalities used in the diagnosis and management of spinal tuberculosis (TB) (Pott’s disease), emphasizing their role in early detection, disease characterization, and treatment monitoring. While plain radiographs serve as a baseline tool, they typically detect the disease only in later stages; advanced imaging modalities such as computed tomography (CT) enable earlier detection of bone destruction, abscess calcifications, and image-guided biopsies. Magnetic resonance imaging, with high sensitivity and specificity, remains the gold standard for visualizing marrow edema, skip lesions, paraspinal/epidural abscesses, and neural involvement, especially with contrast-enhanced, diffusion-weighted, and coronal sequences. Emerging techniques such as dual-energy CT can aid in differentiation of spinal infections from osteolytic metastases. Other techniques such as positron emission tomography-CT and whole-body diffusion weighted imaging with whole-body screening further enhance lesion characterization and response assessment. This review also outlines key reporting features, lesion patterns, imaging protocols, biopsy approaches, and healing markers to aid standardized communication. A question-and-answer format enhances clarity and clinical relevance, making this resource valuable for radiologists and clinicians managing spinal TB.
Velicheti et al. (Mon,) studied this question.