Differentiation of vertebral osteomyelitis and tuberculous spondylitis by magnetic resonance imaging.

Twenty patients with vertebral osteomyelitis and 18 with tuberculous spondylitis were investigated by magnetic resonance imaging to identify the distinguishing features. The number of vertebral bodies involved was less in vertebral osteomyelitis than in tuberculous spondylitis, and the paravertebral abscesses were smaller. The magnetic resonance intensity of the involved vertebral bodies was more homogeneous in vertebral osteomyelitis than in tuberculous spondylitis. Rim enhancement with Gadolinium-DTPA was less frequent in vertebral osteomyelitis. The differentiation of the two conditions by MRI was helpful in establishing the correct diagnosis of the infection.