My partner has been HIV positive for 10 years now and was just diagnosed with TB. He’s had so many tests already. Now they want to do an MRI scan of his entire body. Is this really necessary?

Most people think of tuberculosis (TB) as a pulmonary or lung disease. But in fact, this infection can spread to other parts of the body. The bones and especially the spine can be affected. Spinal TB is also known as Pott’s disease.

The patient with spinal TB may or may not have symptoms. Or there may be back pain at one level when there is spinal TB present in multiple places along the spine. When vertebral bones are affected with normal segments in between, it’s called a skip lesion.

The best way to identify areas of the entire spine affected is by doing whole body MRI. Studies show that only 10 per cent of lesions are identified with X-rays, CT scans, or bone scans. This is true even when all three are used at the same time. But whole body MRI shows a 70 per cent incidence of spinal TB.

Whole body MRI is suggested for anyone suspected of having a spinal infection. Sixty (60) per cent of the HIV positive patients will have skeletal TB. Early detection and intervention can reduce many of the problems that can occur when the spine is affected.

MRI provides important information about location, amount, and type of spinal cord compression, epidural pus, and bone necrosis (bone death). As Ben Franklin once said, An ounce of prevention is worth a pound of cure. Whole body MRI is probably a good idea in this case.