Image Library Kidney Infection TB of the Kidney Link to the Full Case TB KIDNEY, SPINE, EPIDURAL ABSCESS, ADRENAL and PSOAS ABSCESS58-year-old male with known history of tuberculosis. The CXR is normal with no active nor evidence of chronic granulomatous diseaseThe X ray of the lumbar spine shows a compression injury of the L1 vertebral body with compression of the superior endplateCT of the kidney shows replacement of the upper pole of the right kidney with focal hydronephrosis caused by infundibular stenosis and atrophy of the remainder of the right kidney.There is enlargement of the bilateral adrenal glands, with multiple nodular structures encompassing the left adrenal gland, which may also represent infectious process.Examination of the lumbar spine on the CT scan shows findings consistent with TB osteomyelitis with destruction of T12 and L1 vertebral bodies with prevertebral and epidural collections extending into the spinal canal.The left psoas muscle shows peripherally enhancing communicating retroperitoneal and epidural fluid collection as well as multiple peripherally enhancing left psoas fluid collections.Aspiration of the psoas muscle was performedThe MRI confirms the presence of an osteomyelitis discitis associated with an epidural abscess with multiple collections in the left psoas muscleContributed by Christina LeBedis MD Full case TB KIDNEY, SPINE, EPIDURAL ABSCESS, ADRENAL and PSOAS ABSCESSCT of the kidney shows replacement of the upper pole of the right kidney with focal hydronephrosis caused by infundibular stenosis and atrophy of the remainder of the right kidney.Contributed by Christina LeBedis MD Full case TB KIDNEY, SPINE, EPIDURAL ABSCESS, ADRENAL and PSOAS ABSCESS58-year-old male with known history of tuberculosis. CT of the kidney shows replacement of the upper pole of the right kidney with focal hydronephrosis caused by infundibular stenosis and atrophy of the remainder of the right kidney.Contributed by Christina LeBedis MD Full case