Thoracic spine tuberculosis is mainly distinguished from the following diseases: 1, ankylosing spondylitis: most have sacroiliac arthritis, the symptoms are mainly back pain, X-ray examination without bone destruction and dead bone, the thoracic spine is involved with clinical manifestations such as thoracic expansion restriction, serum HLA-B27 is mostly positive; 2, septic spondylitis: rapid onset, high fever and obvious pain, rapid progression, early blood culture can detect pathogenic bacteria, X-ray The performance progresses rapidly, and X-ray can identify its characteristics; 3, lumbar disc herniation: no systemic symptoms, with lower limb nerve root compression symptoms, blood sedimentation is not fast, no bone destruction on X-ray plain film, CT, magnetic resonance examination can find the protruding nucleus pulposus; 4, spinal tumors: mostly seen in the elderly, pain worsens day by day, X-ray plain film can see bone destruction, involving the vertebral arch root, the height of the vertebral space is normal, generally no paravertebral soft tissue mass shadow 5, eosinophilic granuloma: mostly seen in the thoracic spine, more common in children under 12 years old, the entire vertebral body is uniformly compressed in a linear pattern, the upper and lower intervertebral spaces are normal, no fever and other systemic symptoms.