Talk:Pott's disease

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Introduction

Tuberculosis (TB) of the spine (Pott’s disease) is the most common site of bone infection in TB; hips and knees are also often affected. The lower thoracic and upper lumbar vertebrae are the areas of the spine most often affected.

Pathogenesis Of Pott’s Disease

Pott’s disease results from haematogenous spread of tuberculosis from other sites, often pulmonary. The infection then spreads from two adjacent vertebrae into the adjoining disc space. If only one vertebra is affected, the disc is normal, but if two are involved the intervertebral disc, which is avascular, cannot receive nutrients and collapses. The disc tissue dies and is broken down by caseation, leading to vertebral narrowing and eventually to vertebral collapse and spinal damage). A dry soft tissue mass often forms and superinfection is rare. Diagnosis of Pott’s disease Clinical

The disease progresses slowly. Signs and symptoms include:

   * Localised back pain
   * Paravertebral swelling may be seen
   * Systemic signs and symptoms of TB may be present
   * Neurological signs may occur, leading to paraplegia.

Microbiology

   * Needle biopsy of bone or synovial tissue. Numbers of tubercle bacilli present are usually low but are pathognomonic. 
   * Acid-fast stain and culture for Mycobacterium tuberculosis, plus fungi and other pathogens, should be performed.

Imaging

   * Spinal x-ray may not show early disease as 50% of bone mass must be lost for changes to be visible on x-ray. However, plain radiog