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Spinal tuberculosis: overlooked?
1Geriatric Unit, Internal Medicine Department, University of Alexandria, Alexandria, Egypt. suzanraya@yahoo.com
Journal of Internal Medicine
|August 3, 2006
Summary
Tuberculosis (TB) is a common cause of low back pain (LBP), often overlooked. High suspicion is needed as chest X-rays may be normal in spinal TB cases.
Area of Science:
- Rheumatology
- Infectious Diseases
- Orthopedics
Background:
- Low back pain (LBP) is a prevalent condition with diverse etiologies.
- Tuberculous infection of the spine (spinal TB) can present insidiously with LBP.
Purpose of the Study:
- To determine the prevalence of tuberculous infection in patients presenting with LBP.
- To highlight the diagnostic challenges of spinal TB.
Main Methods:
- A cohort study involving 40 consecutive patients with LBP.
- Comprehensive history taking, clinical examination, and investigations were performed.
Main Results:
- Spinal TB was identified as the cause of LBP in 33% (12/40) of patients.
- Many spinal TB cases lacked typical chest X-ray findings and presented with normal spinal X-rays.
- Sputum analysis was negative for acid-fast bacilli in most spinal TB patients.
Conclusions:
- Tuberculosis is an under-recognized cause of LBP, necessitating a high index of suspicion.
- Early diagnosis and treatment of skeletal TB are crucial to prevent severe complications.
- Magnetic resonance imaging (MRI) is suggested as a valuable tool for diagnosing spinal TB.