The diagnosis tends to be delayed because of a nonspecific initial early manifestations andor low degree of suspicion. Mri is the neuroimaging of choice for spinal tuberculosis. The spinal column is involved in less than 1% of all cases of tuberculosis tb. Pott disease tuberculous spondylitis medical article with mri picture, emedicine. Although tb rates are decreasing in the united states, the disease is. Progressive bone destruction leads to vertebral collapse and kyphosis. Spinal tuberculosis is a destructive form of tuberculosis. No response to medical therapy continuing progression of kyphosis or instability. Cervical spine tuberculosis is a less common presentation but is potentially more serious because severe neurologic complications are more. Three mri parameters have been found to be strongly suggestive of spinal tuberculosis.
Pott disease tuberculous tb spondylitis medscape reference. Vertebral collapse of a lesser magnitude is not considered an indication for surgery because. In 1779, percivall pott, for whom the disease is named, presented the classic description o. Pott disease, also known as tuberculous spondylitis, is one of the oldest demonstrated diseases of humankind, having been documented in spinal remains from the iron age in europe and in ancient mummies from egypt and the pacific coast of south america. Meningeal tuberculosis occurs when tuberculosis travels through the bloodstream to the membranes surrounding the brain and spinal cord, called the meninges. The mantoux skin test also known as a tuberculin skin test tst or ppd test. Currently, the term potts diseasepotts spine describes tuberculous infection of the.
Tb of the spine typically occurs following haematogenous spread of mycobacterium tuberculosis from a primary infection site and is characterised by gradual destruction of one or more spinal. Although tb rates are decreasing in the united states, the disease is becoming more common in many parts of the world. The spinal canal can be narrowed by abscesses, granulation tissue, or. The tuberculin skin test also called the mantoux tuberculin test can tell if you have this form of. Images show the thoracic spine before and after an infusion of intravenous gadolinium. Pott disease is tuberculosis of the spine, usually due to haematogenous spread from other sites. Miliary tuberculosis exhibits diffuse nodules at different locations in the body. Tuberculosis tb see the image below, a multisystemic disease with myriad presentations and manifestations, is the most common cause of infectious diseaserelated mortality worldwide. Consequently, further evaluation is necessary with ct scanning or mri.
Although tb rates are decreasing in the united states, the disease is becoming more. Tuberculosis of spine is the most common site of skeletal tuberculosis accounts for 50 percent of the cases and may cause neural symptoms as well. Which testing is needed when vertebral pott disease or brain. Pott disease tuberculous tb spondylitis clinical presentation. Pott disease, also known as tuberculous spondylitis, is a classic presentation of extrapulmonary tuberculosis tb. Other infectious afflictions of spine like brucella, pyogenic.
Mri of a 31yearold man with tuberculosis of the spine. Pathophysiology and treatment of spinal tuberculosis. Spinal tb is a very dangerous type of skeletal tb as it can be associated with neurologic deficit due to compression of adjacent neural structures and significant spinal deformity. Lesions in the thoracic spine are more likely to lead to kyphosis than those in the lumbar spine.
Other granulomatous processes, particularly brucellosis. Tuberculosis infection of the second cervical spine is a very rare case and has an incidence rate of only 1 in 100,000. Until the introduction of effective anti tuberculosis drugs, treat ment for tuberculosis of the spine required enforced recumbency, im mobilization and hospitalization for several years, preferably in special. Advanced imaging techniques such as magnetic resonance imaging mri make the early diagnosis of spinal tb easier and a considerable. Reactivated tb bacteria usually infiltrate the upper lobes of the lungs. Pdf management of tuberculous infection of the spine. Both gluteal abscess and sacral tuberculosis are rare entities in spinal tuberculosis cases. Tuberculosis of spine presentation and treatment bone. It is associated with significant morbidity and can lead to severe functional impairment. What is the pathophysiology of the spinal tuberculosis. Cervical spine tuberculosis is a less common presentation but is potentially more serious because severe neurologic complications are more likely.
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