(ii) MRI of spinal infection

Magnetic resonance imaging (MRI) is the imaging modality of choice for spinal infection. In most cases a firm diagnosis can be made distinguishing infection from other destructive conditions such as malignant disease. There are however pitfalls, with a number of conditions which can mimic infection including degenerative disease, malignancy, pseudarthrosis and avascular necrosis. There are imaging features which suggest tuberculous infection rather than the more common pyogenic infection, which is typically S. aureus. Imaging however can never replace the microbiologist and percutaneous biopsy is usually required, using either CT or fluoroscopy to guide the biopsy needle.