Text in Italics is general (instructional) information
Differential Diagnosis 1) Hypernephroma
2) Tuberculous spondilitis
The ESR was 41 mm/hr The Pedicle was absent on L1 and the most likely diagnosis was hypernephroma with lumbar metastasis. The other possibility was tuberculosis. There was slight disc space narrowing between T12 and L1 vertebrae. This case required biopsy to make the final diagnosis.
Open Biopsy was done. Histology showed grannuloma formation supporting the diagniosis of tuberculosis. The boy's condition improved on anti TB medication and, 1 year later, he was symptom free.