Tuberculosis remains an important problem in underdeveloped countries, especially in individuals under the age of 20 years. In developed countries, there was an increase of the disease due to several factors, especially the appearance of A.I.D.S. The arterial haematogenous seeding is the most important way to the propagation of the disease to the rachis. The bacillus mycobacterium tuberculosis is characterized by a slow growth, propention for an oxygen rich environment and the absence of proteolytic enzymes. These characteristics are responsible for the imaging particularities of tuberculous osteomyelitis. The diagnosis can be confirmed by the bacteriologic and histological studies from samples removed by punction biopsy. (C) 2005 Published by Elsevier Ireland Ltd.