Pott's disease
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Tuberculosis_spine_mummy.jpg
Pott's disease is a presentation of extrapulmonary tuberculosis that affects the spine, a kind of tuberculous arthritis of the intervertebral joints. More precisely it is called tuberculous spondyloarthropathy and the original name was formed after Percivall Pott (1714-1788), a London surgeon. It is most commonly localized in the thoracic portion of the spine. The fictional Hunchback of Notre Dame had a gibbous deformity (humpback) that is thought to have been caused by tuberculosis.
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Signs and symptoms
- back pain
- fever
- night sweating
- anorexia
- weight loss
- Spinal mass, sometimes associated with numbness, tingling, or muscle weakness of the legs
Diagnosis
- blood tests - elevated blood sedimentation rate
- tuberculin skin test
- radiographs of the spine
- bone scan
- CT of the spine
- bone biopsy
Late complications
- Vertebral collapse resulting in kyphosis
- Spinal cord compression
- sinus formation
- paraplegia (so called Pott's paraplegia)
Therapy
- non-operative - antituberculous drugs
- analgesics
- immobilization of the spine region
- Surgery may be necessary, especially to drain spinal abscesses or to stabilize the spine
Prevention
Controlling the spread of tuberculosis infection can prevent tuberculous spondylitis and arthritis. Patients who have a positive PPD test (but not active tuberculosis) may decrease their risk by properly taking medicines to prevent tuberculosis. To effectively treat tuberculosis, it is crucial that patients take their medications exactly as prescribed.
External links
- Pott Disease (http://www.emedicine.com/med/topic1902.htm) Tuberculous Spondylitis - from eMedicine - medical article with MRI picture
- Tuberculous arthritis (http://www.nlm.nih.gov/medlineplus/ency/article/000417.htm). MedlinePlus. Public domain text from the US Government.