Learning objectives
To outline the Radiological features of Tuberculous (TB) Spondylitis using cases from a National TB Referral centre.
To review the imaging modalities involved in assessment of disease and compare and contrast them using varied examples.
To illustrate the classic radiological features of TB Spondylitis and the differential diagnoses.
Background
TB Spondylitis is one of the oldest diseases of mankind having been found in Egyptian Mummies dated as far back as 4000BC.
Bone and Joint infection account for 10-35% of extrapulmonary TB but only 2% of overall TB worldwide.This ancient disease has experienced a recent resurgence most notably in the immunocompromised host and the development of multidrug resistant strains.
Prevalence is highest in Africa and lowest in The Americas but due to better transport links and increasing population TB is a global problem.
The vertebral...
Imaging findings OR Procedure details
Plain Film,
CT and MRI all have roles in diagnostic imaging of TB Spondylitis.
Plain Film
Non specific plain film abnormalities such as osteopenia and soft tissue swelling can point the Radiologist towards the right diagnosis in the appropriate clinical setting.
Examples below Demonstrate bony abnormalities from the cervical spine down to the lumbar spine in our patient cohort.
In all cases plain film was the first investigation performed.
CT vs MRI
CT is superior to MRI in the evaluation of the degree of bony...
Conclusion
The total number of cases of TB is rising globally due to rising population in developed countries.
Although a post primary manifestation,
over half the cases of TB Spondyltis present with no active pulmonary disease.
For a clinician in an area of low incidence it can be difficult to diagnose due to its insidious nature and low index of suspicion.
Radiologists play a vital role in disease assessment and diagnosis.
Subtle plain film findings on routine exams in the right clinical scenario can make the...
Personal Information
J Kavanagh¹,
R Dunne²,
J Keane¹,
A Mc Laughlin¹
Department of Respiratory¹,Department of Radiologyl²,
University of Dublin Teaching Hospital,
St James Hospital,
James Street,
Dublin 8,
www.stjames.ie
Mail:
[email protected]
References
Daniel,
TM,
Bates,
JH,
Downes,
KA.
History of tuberculosis.
In: Tuberculosis: Pathogenesis,
Protection,
and Control,
Bloom,
BR (Ed),
American Society for Microbiology,Washington,
1994,
p.
13.
Martini M,
Ouahes M.
Bone and joint tuberculosis:a review of 652 cases.
Orthopedics 1988;11(6):861–866.Martini M,
Ouahes M.
Bone and joint tuberculosis:a review of 652 cases.
Orthopedics 1988;11(6):861–866.
Jain R,
Sawhney S,
Berry M.
Computed tomography of vertebral tuberculosis: patterns of bone destruction.Clin Radiol 1993;47(3):196–199.48.
Weaver P,
Lifeso R.The radiological diagnosis of tuberculosis of the adult spine.
Skeletal Radiol 1984;12(3):178–186.
Floyd...