Detection of Spinal Tuberculosis by F-18 FDG PET/CT as a Cause of Unusual Referred Pain in the Right Upper Quadrant of Abdomen.

Tuberculous involvement of the spine (tuberculosis [TB] spine) can cause severe morbidity unless detected and treated early. Apart from the constitutional symptoms, it can present with back pain, kyphosis, gait abnormality, and paraplegia secondary to the bone or spinal cord involvement. There had been instances of TB spine presenting directly as abdominal pain due to psoas abscesses. Herein, we report a very rare clinical manifestation of TB spine as referred pain in the right upper abdominal quadrant due to right epidural phlegmon associated with T7 vertebra, detected by positron emission tomography.