Brucellosis is endemic, occurring mostly in the northeastern and northwestern pastoral areas, with three main groups of people susceptible to infection: those with a history of contact with diseased animals in agricultural and pastoral areas; laboratory workers in contact with specimens containing bacteria; and people who have consumed unsterilized dairy products or undercooked beef or lamb. The disease is most likely to invade the spine, and its epidemiology has changed from a primarily occupationally related disease to one primarily caused by food. Whereas tuberculosis is more widespread, spinal tuberculosis is mainly caused by infection with pulmonary, gastrointestinal or lymphatic tuberculosis. Mycobacterium bovis and Mycobacterium tuberculosis infections can affect any part of the spine, with the former predominantly in the lumbar spine, with the highest incidence in L4, and the latter in the thoracolumbar segment, with the highest incidence in L1 and 2. X-ray manifestations: (1) vertebral inflammation: marginal bone destruction is most common in Brucella spondylitis, with multifocal lesions, mostly affecting one to two vertebral bodies on the upper edge, and a few for three vertebral bodies. Early manifestations are small bony sparse foci, with foci of bone loss appearing after a few weeks, and larger foci are island-like. The lesions are soft tissue dense with clear sharp margins, irregular worm-like destruction or a knife-saw appearance, and later sclerosis and hyperplasia form bone spurs that extend outward or adjacent to the vertebral body margin in a bird’s beak shape, forming a bone bridge. The center of the vertebral body may also be invaded, but usually the central lesion of the vertebral body rapidly hardens without forming a deep bone destruction defect, which is gradually replaced by new bone without signs of vertebral compression. In spinal tuberculosis, whether central or marginal, bone destruction soon invades the intervertebral disc and two to three adjacent vertebral bodies, with jumping destruction, osteolytic foci of bone destruction, cavities in the center of the vertebral body, uneven density, and dead bone formation, widening of the paravertebral soft tissue shadow, blurring of normal muscle shadow, and multiple calcification shadows in chronic cases; later the vertebral body compresses into a wedge shape, narrowing in the front and widening in the back, with kyphosis. (2) Intervertebral microarthritis: B. burgdorferi spondylitis mostly occurs in the adjacent lesioned vertebrae, with irregular destruction of the joint surface and progressive narrowing of the joint space to the point of disappearance, which may also manifest as secondary proliferative arthritis, producing bony ankylosis and simultaneous invasion of several joints. These manifestations are rarely seen in spinal tuberculosis. (3) Calcification of the ligaments: brucellosis spondylitis is more common in the lower lumbar spine and is characterized by the progressive development of a cord-like calcification of the anterior and posterior longitudinal ligaments from the bottom up; tuberculosis of the spine has no such manifestations. (4) Intervertebral discitis: Brucella spondylitis may have early intervertebral space narrowing with increased density but no tendency for destruction of the vertebral endplates; spinal tuberculosis shows progressive destruction of the vertebral endplates and discs with uneven density reduction and extreme narrowing or loss of the intervertebral space. CT manifestations: (1) bone changes: the foci of bone destruction in brucellosis spondylitis are mostly multiple, circular, low-density foci no more than 5 mm in diameter, with coarse and disorganized bone trabeculae and unclear structure, with apparently varying degrees of hyperplastic sclerotic bands at the edges of the foci, mostly at the edges of the vertebral body, with new foci of destruction in the new bone, a few in the center of the vertebral body, and similar changes in the small vertebral joints, with a general increase in density in the adjacent vertebral body, without dead The adjacent vertebral body is generally dense, without dead bone or arch destruction; vertebral tuberculosis is osteolytic bone destruction, and the foci of destruction often involve one or most of the vertebral body. Multiple irregular dead bones are seen in the foci of destruction, and posterior destruction of the vertebral body often involves the vertebral arch, with a general decrease in density of the adjacent vertebral body. (2) intervertebral disc changes: both vertebral body destruction is accompanied by adjacent intervertebral space narrowing, intervertebral disc destruction, but brucellosis spondylitis CT shows isodensity, is the result of intervertebral disc destruction often accompanied by a large amount of fibrous tissue hyperplasia, osteoarticular surface hyperplasia sclerosis; while spinal tuberculosis CT shows intervertebral disc destruction, density is not uniform, there are full of star-like dead bone scattered in it, osteoarticular surface irregular destruction or disappearance . (3) paravertebral abscess: both paravertebral soft tissue shadows are connected to the vertebral body destruction area with irregular morphology and clear boundaries, pushing against the adjacent psoas major muscle. (5) periosteal changes: B. burgdorferi spondylitis vertebral body periosteal hypertrophy, from the middle to both sides of the expansion, so that the vertebral body is mottled uneven density increase, pike deformation, vertebral body edge periosteal hyperplasia, calcification, the formation of lip-shaped bone superfluous, new bone superfluous plus the foci of destruction between them constitute the characteristic performance of the lace vertebrae, but the calcified periosteum and vertebral body is still clearly identifiable. The lateral fusion of the vertebrae is formed by the connection of adjacent vertebral bodies. Sometimes the periosteum of the transverse process shows a cap-like thickening at the top of the transverse process. Spinal tuberculosis has none of these manifestations. (6) Ligamentous changes: brucellosis spondylitis is mainly manifested by calcification of the anterior longitudinal ligament and interspinous ligament; spinal tuberculosis does not have such changes. MRI manifestations: In addition to CT manifestations, abnormal signals of bone and surrounding involved soft tissues, narrowing of the intervertebral space, heterogeneous signals of the vertebral body, epidural abscesses in the spinal canal, disrupted intervertebral discs or inflammatory granulation tissue protruding into the spinal canal or calcification of the posterior longitudinal ligament can be detected early, causing spinal cord compression in the corresponding plane. enhanced signals of the abscess margins on MRI suggest spinal tuberculosis. Spinal tuberculosis involves the thoracolumbar segment and more vertebral bodies than in patients with brucellosis spondylitis, who typically present with a horizontal band deficit in the lumbar vertebral body. The most reliable MR I features of spinal TB are jumpy lesions and thin, smoothly enhancing abscess walls and well-defined paraspinal abnormal signals, whereas MRI of brucellosis spondylitis is characterized by thick, irregularly enhancing abscess walls and ill-defined paraspinal abnormal signals, with low signal T1W I and high signal T2W I to the point of significant bone destruction, high signal T2W I, and lipid suppression like vertebral bodies, intervertebral discs, adnexa, and The spinal canal showed heterogeneous high signal.