Diagnosis of Spine Tuberculosis

Click here to load reader

Embed Size (px)

Transcript of Diagnosis of Spine Tuberculosis

PowerPoint Presentation

DiagnosingTuberculosis SpineBy Jagjit Khosla

Diagnosis of TB spineHistoryExaminationInvestigationDiagnosis

History

Symptoms of tb spine

Back PainStiffnessSwelling at backParaplegiaDeformity12345

Symptoms of tb spineConstitutional symptoms6

Evening rise of tempNight sweatsWeight loss and anorexia+ Previous history of Pulmonary TB or Contact history

Back Pain

Back painNot since birthNo H/o Trauma/Lifting weight or strenuous exercises preceding painNo other bone or joint problemsNon radiating painNo Morning stiffnessNo H/o Haematuria, dysurea, oliguriaNo H/o Menstrual problems

CongenitalTraumatic/ Prolapsed discNeoplasticProlapsed discAnkylosing spondylitisGenito-urinaryGynaecological

Examination

On examinationKyphotic deformity

On examination

Spinal movements restrictedParavertebral swelling

examinationStraight Leg raising test

Cough impulse over swelling

Prolapsed discMeningocele (spina bifida)

INVESTIGATIONS

investigationsX-RAY AP and Lateral viewMRIC.T. ScanMyelographyBiopsyIx for Primary focus Chest X-ray, X-ray KUBGeneral Investigations

Normal Vertebral column

Normal X-ray spine

AP VIEWLateral view

X-ray spine in tb spine

Reduced disc space1

Earliest signLateral xrayWell preserved in secondaries, other spine diseases16

X-ray spine in tb spine

Decreased height of vertebra2

X-ray spine in tb spine

destruction of vertebral body3

X-ray spine in tb spine

destruction of vertebral body3

X-ray spine in tb spineCold abscess4

Retropharyngeal abscess

X-ray spine in tb spineCold abscess4

Widened mediastinum

X-ray spine in tb spineCold abscess4

Para vertebral Fusiform abscess

X-ray spine in tb spineCold abscess4

Psoas abscess

MRI in tb spine

Abscess1Vertebral destruction2Spinal cord compression3

Ct scan in tb spine

Extent of destruction1abscesses2

Other investigationsMyelography Level of nerve lesionBiopsy - EtiologyChest X-rayX-ray KUBGeneral Investigations ESR, Mantoux, ELISA

Primary focus of TB

Thank you