Purpose: To analyze the diagnostic value of MRI for distinguishing tuberculous from pyogenic spondylitis confirmed by histology results and to determine the cutoff point score of MRI. Subjects and methods: Observational analytic design with a cross-sectional approach. Data were collected from radiology and pathology anatomy medical records, therefore no informed consent was obtained. We utilized diagnostic tests using 2×2 tables and receiver operating characteristic curve to obtain the value of the sensitivity, specificity, accuracy, and area under curve (AUC) of MRI. Twenty-eight samples were selected, consisting of 20 samples of tuberculous spondylitis and 8 samples of pyogenic spondylitis. Results: The radiological diagnosis using MRI had a sensitivity of 85%, specificity of 87.5%, positive predictive value of 94.4%, negative predictive value of 70%, and accuracy of 85.7%. AUC value was 91.6%, p = 0.001. MRI with a score ≥4 had sensitivity of 90%, specificity of 87.5%, positive predictive value of 94.7%, negative predictive value of 77.8%, and accuracy of 89.2%. Conclusion: MRI had a high diagnostic value with AUC value of 91.6% for distinguishing tuberculous from pyogenic spondylitis, confirmed by histology results. MRI, with a score of ≥4, had a higher diagnostic value compared with the reading of MRI without using scores.

Introduction: Erdheim-Chester disease (ECD) is a rare form of non-Langerhans-cell histiocytosis which typically presents with bilateral masses due to retro-orbital deposition, xanthelasma of the eyelids, cardiopulmonary manifestations, along with sclerosis and cortical thickening of the long bones, particularly in the lower extremities.Case Report: We present the case of a 58-year-old male who presented to a local emergency department with a one day history of severe dizziness, diaphoresis, dyspnea, and intermittent diplopia. Imaging demonstrated bilateral symmetric retrobulbar masses. Subsequent imaging as well as orbital and bone marrow biopsies lead to the diagnosis of ECD. Conclusion:Erdheim-Chester disease is a rare form of non-Langerhans-cell histiocytosis. This case demonstrates classic clinical and imaging findings representative of ECD. Diagnostic imaging and pathologic findings play a vital role in the diagnosis and choice of therapy in patients with ECD. Although interferon is currently considered to be first-line therapy, targeted

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