Tuberculosis of the Lower Lumbar Spine with an Atypical Radiological Presentation - A Case Mimicking a Malignancy -

Jahng, Juhae; Kim, Young-Hoon; Lee, Kyo-Sun

doi:10.4184/asj.2007.1.2.102

Cited by 8 publications

(4 citation statements)

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“…However, spinal TB with atypical clinical and radiographic findings can result in a delayed diagnosis. 12 Several different features of atypical radiological presentation of TB have been described and reported. 13,14 Atypical features described are (1) involvement of spinal posterior element with sparing of anterior column; (2) skipped lesions; and (3) neural component compression as a result of tuberculosis granuloma.…”

Section: Discussionmentioning

confidence: 99%

Spinal tuberculosis: Our experience and a review of imaging methods

et al. 2015

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We share our experience of 2000 spinal tuberculosis (TB) cases, including both typical and atypical presentations. The aim of the study is to estimate the incidence and types of spinal TB referred to our department for diagnosis. 2000 patients were selected by convenience sampling from January 2006 to September 2010. Study design was descriptive and among 2000 mostly unknown cases without evidence of symptoms of systemic TB (1080 males and 920 females). MRI without and with IV contrast, CECT with MPR, and in some cases not fit for MRI, CT myelography, were performed. Out of 2000 cases of tuberculous spine, 1080 (54%) were male and 920 (46%) were female. Their age ranged from 8-60 years. About 90% of patients were below the age of 40 years. Peak age among the males and females was 20-29 years and 14-35 years, respectively. The most common site of involvement was dorsal spine (45%) followed by lumbo-sacral spine (33%), cervical spine (10%) and at multiple levels (12%). Biopsies were done in 240 (12%) cases. Spinal TB should always be suspected when radiographs demonstrate a destructive spinal process. Awareness and prompt management of TB spine will help in reducing the continuing morbidity of this disease.

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Section: Discussionmentioning

confidence: 99%

Spinal tuberculosis: Our experience and a review of imaging methods

et al. 2015

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“…Drug chemotherapy + Surgery Better Jahng et al 21 65/F Back and leg pain, Hypesthesia L1, L5, S1 Drug chemotherapy + Surgery Better Singh et al 22 26/M Back pain T2, T6, T7, L1, L5, S1, S2…”

Section: Laboratory Examinationmentioning

confidence: 99%

Diagnosis and Treatment of Skipped Multifocal Spinal Tuberculosis Lesions

Lyu

Zhang

2023

Orthopaedic Surgery

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Spinal tuberculosis, also known as Pott's disease or tuberculous spondylitis, is usually secondary to primary infection in the lungs or other systems, and in most instances, is thought to be transmitted via blood. Typical manifestations of infection include narrowing of the intervertebral disc by erosion and bone destruction of adjacent vertebrae. Atypical spinal tuberculosis is a specific type of spinal tuberculosis. It mainly consists of single vertebral lesions, single posterior structure lesions, multiple vertebral lesions, and intra-spinal lesions. Skipped multifocal spinal tuberculosis is one of these types and is characterized by two or more vertebral lesions without the involvement of the adjoining intervertebral discs, regardless of their location. To date, only a few cases have been reported. Upon clinical admission, it can be treated conservatively or surgically, depending on the patient's symptoms. In addition, gene or biological therapies are being investigated. However, because of the exceptional imaging findings and insidious symptoms, it is often misdiagnosed as a neoplastic lesion, osteoporotic fracture, or other infectious spondylitis, increasing the risk of neurological deficit and kyphotic deformity, and delaying the optimal treatment window. In this study, we review the diagnosis and treatment strategies for skipped multifocal spinal tuberculosis lesions and enumerate the common differential diagnoses, to provide reference and guidance for clinical treatment and diagnosis direction.

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“…한편, 잦은 외상 또는 스트레스 등에 의해서도 골막 반응이 나타날 수 있으며 이는 주로 양성 소견을 보이며 균 질하면서도 연속적인(solid uninterrupted) 양상이다. 2) 현재까지 저 자들의 문헌 고찰 결과, 운동 선수에서 만성적 스트레스(stress)로 야기된 "악성 종양에서 보이는 골막 반응"이 2예, 3,4) 치골 부위의 외상으로 역시 "악성 종양에서의 골막 반응"이 보인 1예, 5) 결핵으 로 인한 "악성 종양의 골막 반응"이 보인 1예 6 상의 골막 반응이 골절 부위와 근처에서 관찰된다. 8,9)…”

Section: 대한정형외과학회지：제 46권 제 6호 2011unclassified