Diagnosis of pulmonary tuberculosis. 2 PULMONARY TUBERCULOSIS.
Diagnosis of Spine Tuberculosis
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Transcript of Diagnosis of Spine Tuberculosis
DIAGNOSING…TUBERCULOSIS SPINE
By Jagjit Khosla
DIAGNOSIS OF TB SPINE
History
Examination
Investigation
Diagnosis
HISTORY
SYMPTOMS OF TB SPINE
Back PainStiffnessSwelling at back
ParaplegiaDeformity
12345
SYMPTOMS OF TB SPINE
Constitutional symptoms6
Evening rise of temp Night sweats Weight loss and anorexia
+ Previous history of Pulmonary TB or Contact history
BACK PAIN
Congenital
Traumatic
Inflammatory
Neoplastic
Degenerative
Metabolic
BACK PAIN Not since birth No H/o Trauma/Lifting weight or
strenuous exercises preceding pain No other bone or joint problems Non radiating pain No Morning stiffness No H/o Haematuria, dysurea, oliguria No H/o Menstrual problems
Congenital
Traumatic/ Prolapsed disc
NeoplasticProlapsed disc
Ankylosing spondylitis
Genito-urinary
Gynaecological
EXAMINATION
ON EXAMINATION
• Kyphotic deformity
ON EXAMINATION
Spinal movements restricted
Paravertebral swelling
EXAMINATION Straight Leg raising test
Cough impulse over swelling
Prolapsed disc
Meningocele (spina bifida)
INVESTIGATIONS
INVESTIGATIONS
• X-RAY – AP and Lateral view• MRI• C.T. Scan• Myelography• Biopsy• Ix for Primary focus – Chest X-ray, X-ray KUB• General Investigations
NORMAL VERTEBRAL COLUMN
NORMAL X-RAY SPINE
AP VIEW LATERAL VIEW
X-RAY SPINE IN TB SPINE
REDUCED DISC SPACE
1
X-RAY SPINE IN TB SPINE
DECREASED HEIGHT OF VERTEBRA
2
X-RAY SPINE IN TB SPINE
DESTRUCTION OF
VERTEBRAL BODY
3
X-RAY SPINE IN TB SPINE
DESTRUCTION OF
VERTEBRAL BODY
3
X-RAY SPINE IN TB SPINE
COLD ABSCESS
4
Retropharyngeal abscess
X-RAY SPINE IN TB SPINE
COLD ABSCESS
4
Widened mediastinum
X-RAY SPINE IN TB SPINE
COLD ABSCESS
4
Para vertebral Fusiform abscess
X-RAY SPINE IN TB SPINE
COLD ABSCESS
4
Psoas abscess
MRI IN TB SPINE
ABSCESS
1
VERTEBRAL DESTRUCTION
2SPINAL CORD
COMPRESSION
3
CT SCAN IN TB SPINE
EXTENT OF DESTRUCTION1 ABSCESSES2
OTHER INVESTIGATIONS
• Myelography – Level of nerve lesion• Biopsy - Etiology• Chest X-ray• X-ray KUB• General Investigations – – ESR, Mantoux, ELISA
Primary focus of TB
Thank you…