Anterior and paravertebral soft tissue swelling or abscesses are one of the important features in the diagnosis and differential diagnosis of spinal tuberculosis, and in particular, calcification of abscesses is often specific. Anterior paravertebral soft tissue swelling or abscess is commonly seen in cases of spinal tuberculosis with extensive and severe destruction of the vertebral body and adnexa. 1.X-ray examination (1) Bone and joint changes Bone destruction and narrowing of the vertebral space are predominant on X-rays. Generally, there are no positive X-ray signs within 2 months after the onset of the disease. Therefore, repeated radiographs or other examinations are needed for suspicious cases. In the central type, the bone destruction is concentrated in the center of the vertebral body and is clearer in lateral views. The vertebral body soon appears to be compressed into a wedge shape, narrowing anteriorly and widening posteriorly. It can also invade the intervertebral discs and involve the adjacent vertebral bodies. In the marginal type, the bone destruction is concentrated at the superior or inferior edge of the vertebral body and soon invades the intervertebral disc, showing destruction of the vertebral endplates and progressive narrowing of the intervertebral space with involvement of the two adjacent vertebral bodies. The bone destruction and wedge compression in the marginal type are less pronounced than in the central type, so the kyphosis is not heavy. (2) Cold abscess The manifestations are widened anterior soft tissue shadow and anterior displacement of the trachea on lateral cervical spine radiographs; widened paravertebral soft tissue shadow, which may be spherical, spindle-shaped or cylindrical, is seen on orthopantomographs of the thoracic spine and is generally asymmetric. In lumbar orthopantomographs, abscesses of the psoas major muscle may appear as blurring of the shadow of the psoas major muscle on one side, or as widening, fullness, or limited elevation of the psoas major muscle shadow, and the abscess may even flow into the hip and femoral triangle. In chronic cases, multiple calcified shadows can be seen. 2.CT examination can clearly show the site of the lesion, and cavity and dead bone formation can be seen. Even small paravertebral abscesses can be detected during CT examination, which is uniquely valuable for detecting abscesses of the psoas major muscle. 3.MRI (magnetic resonance imaging) examination has early diagnostic value and can show abnormal signals at the stage of inflammatory infiltration, and can also be used to observe whether the spinal cord is compressed and degenerated.