X ray of spine

please give your comments on this x ray in relation to pulmonary diseases

Today is "world TB day" the theme this year(2012) is "Stopping TB in My Lifetime." Each year, more than 9 million people around the world get infected with TB and almost two million TB related deaths are recorded worldwide. The real scenario may be much fearful.India contributes nearly 20% of the world TB cases. Each year nearly 2 million people in India develop this deadly disease. we as pulmonologist has grater responsibility than any other specialty but are we a TB doctors. The public perception is like that even other doctors think we have done specialization in TB. This is ridiculous. when we done our PG we get specialize in every pulmonary disease. the common ones are COPD, Asthma, TB, Interstitial lung diseases, Pneumonias, Lung cancer, bronchiectesis. Other recent addition are sleep disorders and critical care. we learn bronchoscopy, lung and pleural biopsy, pleuroscopy,which are specialist procedure. so we actually are more than TB doctor. But people don't want let us recognize in the community due to fear of loosing their base.But there are many other problem...what r those ? Comments.........

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dfferential diagnosis ?

SPOT THE DIAGNOSIS