HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cormican, L Articles by Milburn, H J Search for Related Content PubMed PubMed Citation Articles by Cormican, L Articles by Milburn, H J

Current difficulties in the diagnosis and management of spinal tuberculosis

Department of Respiratory Medicine, Guy’s and St Thomas’ NHS Hospitals Trust, London, UK

Correspondence to:
Correspondence to:
Dr L Cormican
Department of Respiratory Medicine, Second Floor, Thomas Guy House, Guy’s Hospital, St Thomas Street, London SE1 9RT, UK; liam.cormican{at}kingsch.nhs.co.uk

Background: The diagnosis of spinal tuberculosis (ST) is difficult and it commonly presents at an advanced stage. The management and follow up is complicated by a lack of guidance on the appropriate use and interpretation of spinal magnetic resonance studies (MR).

Aims: A retrospective study was performed at a UK centre to identify the demographic and presenting features of a spinal TB population, their response to treatment, and the value of follow up MR studies.

Patients and Results: Twenty one patients were identified with mean symptom duration of 11 (1.5–36) months having been assessed by a health practitioner on 3.2 (0–10) occasions before referral for investigation for ST. Twenty were born outside the UK. Their mean duration of residence in the UK was 6.67 (0.75–20) years, and six (32%) were resident for more than 10 years. Most (85.7%) did not have a medical history and one was HIV positive. Back pain, neurological, and constitutional symptoms were found in 100%, 29%, and 38% respectively. Musculoskeletal and neurological signs were found in 29% and 19% respectively. Spinal MR performed between 6 and 12 months suggests that six months of chemotherapy (for a fully sensitive organism) may not be sufficient to achieve disease resolution.

Conclusions: Awareness of the demographic, clinical, and laboratory features of an ST population may facilitate earlier diagnosis. Guidance is required on the appropriate use and interpretation of MRI in the follow up of these patients.

Abbreviations: TB, tuberculosis; MR, magnetic resonance

Keywords: spinal tuberculosis; diagnosis; duration; management

This article has been cited by other articles:

				H. Milburn Key issues in the diagnosis and management of tuberculosis J R Soc Med, March 1, 2007; 100(3): 134 - 141. [Full Text] [PDF]