Pulmonology Book

Tuberculosis

  • Skeletal Tuberculosis

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Skeletal Tuberculosis

Aka: Skeletal Tuberculosis, Tuberculous Arthritis, Pott's Disease, Poncet's Disease, Spinal Tuberculosis, Articular Tuberculosis, Tuberculous Osteomyelitis, Gibbus
  1. See Also
    1. Tuberculosis
    2. Septic Arthritis
    3. Extrapulmonary Tuberculosis
  2. Definition
    1. Arthritis secondary to Mycobacterium tuberculosis
  3. Epidemiology
    1. Represents 35% of Extrapulmonary Tuberculosis
  4. Distribution
    1. Spinal Tuberculosis (Pott's Disease)
      1. Thoracic Spine most commonly involved
      2. Associated with paraspinous abscess
      3. Destroys anterior Vertebral body and adjacent disc
        1. Results in anterior wedging
        2. Forms prominence of spine known as Gibbus
        3. May compress central cord
    2. Articular Tuberculosis (most common involvement)
      1. Monoarticular Arthritis of weight bearing joints
      2. Presents with insidious monoarticular pain, swelling
      3. May form superficial abscesses and drain to skin
    3. Poncet's Disease (rare)
      1. Acute sterile Polyarthritis
      2. Associated with visceral involvement
    4. Tuberculous Osteomyelitis
      1. May involve any bone
  5. Signs
    1. Doughy synovitis on joint palpation
  6. Labs
    1. Tuberculin Skin Test (Purified Protein Derivative)
      1. Positive in most cases
    2. Synovial Fluid Exam
      1. See Septic Arthritis
  7. Radiology: Chest XRay
    1. Pulmonary involvement in only 50% of Tb arthritis
  8. Diagnosis
    1. Arthrocentesis with Mycobacterium tuberculosis culture
      1. Test Sensitivity: 80%
    2. Synovial biopsy
  9. Management
    1. See Extrapulmonary Tuberculosis
    2. See Tuberculosis Management
    3. Four drug regimen
      1. Isoniazid for 10 to 24 months
      2. Rifampin for 10 to 24 months
      3. Pyrazinamide for 2 months
      4. Ethambutol until Tuberculosis sensitivity established
      5. Atypical Mycobacteria require fifth drug added
        1. Azithromycin or
        2. Clarithromycin
  10. References
    1. Watts (1996) J Bone Joint Surg Am 78:288-98

Tuberculosis, Spinal (C0041330)

Definition (MSH) Osteitis or caries of the vertebrae, usually occurring as a complication of tuberculosis of the lungs.
Concepts Disease or Syndrome (T047)
MSH D014399
ICD9 015.00, 015.0
ICD10 M49.0, A18.01
SnomedCT 50509001, 203262001, 186230007, 35984006
English Spinal Tuberculoses, Spinal Tuberculosis, Tuberculoses, Spinal, POTT DISEASE, SPINE, TUBERCULOSIS, SPONDYLITIS, TUBERCULOUS, TB vertebral column - Pott's, Tuberculosis of spine, Tuberculosis of vertebral column, unspecified examination, TUBERCULOUS SPONDYLITIS, Pott's disease (diagnosis), Tuberculosis of spine (disorder), Tuberculous spondylitis (disorder), Tuberculosis of spinal cord, TB spine, Tuberculous spine, TB of vertebra-unspec, Tuberculosis, Spinal [Disease/Finding], Tuberculosis of vertebral column, unspecified, spine tuberculosis, disease pott's, pott's disease, potts disease, spinal cord tuberculosis, pott disease, spine tuberculous, tuberculous spondylitis, diseases pott, disease pott, spine tb, tb spine, tuberculosis of spine, tuberculosis spinal, tuberculosis spine, spinal tuberculosis, diseases pott's, disease potts, Pott's Disease, Pott Disease, POTT DIS, POTTS DIS, Disease, Pott's, Disease, Pott, Potts Disease, Tuberculosis, Spinal, Tuberculous spondylitis, Tuberculosis of vertebral column, Pott's disease, Tuberculosis of vertebral column - Pott's, Tuberculosis of spine (Pott's), Tuberculosis of vertebral column (disorder), Pott; disease (etiology), Pott; disease (manifestation), disease (or disorder); spine or vertebra, tuberculous (etiology), disease (or disorder); spine or vertebra, tuberculous (manifestation), spine or vertebra; disorder, tuberculous (etiology), spine or vertebra; disorder, tuberculous (manifestation), Tuberculous spondylitis -RETIRED-
Dutch ziekte van Pott, ruggengraattuberculose, wervelkolomtuberculose, wervelkolomtuberculose, niet-gespecificeerd onderzoek, tuberculeuze ruggengraat, TBC ruggengraat, tuberculose van ruggenmerg, Pott; ziekte, aandoening; wervel{kolom}, tuberculeus, wervel{kolom}; aandoening, tuberculeus, Tuberculose van wervelkolom, Pott, ziekte van, Tuberculose, spinale, Tuberculose, wervelkolom-, Wervelkolomtuberculose, Ziekte van Pott
French TB rachidienne, Tuberculose de la moelle épinière, Rachis tuberculeux, Maladie de Pott, Tuberculose de la colonne vertébrale, examen non précisé, Tuberculose de la colonne vertébrale, Spondylodiscite tuberculeuse, Tuberculose vertébrale, Mal de Pott, Spondylite tuberculeuse, Tuberculose du rachis, Tuberculose rachidienne
German Tuberkulose der Wirbelsaeule, Tuberkulose des Rueckenmarks, TB Wirbelsaeule, Tuberkulose der Wirbelsaeule, unspezifische Untersuchung, tuberkuloese Wirbelsaeule, Spinale Tuberkulose, Tuberkulose, spinale, Pott-Krankheit, Wirbelsäulentuberkulose
Italian Tubercolosi del midollo spinale, Tubercolosi vertebrale, Tubercolosi della colonna vertebrale, esame non specificato, Tubercolosi della colonna vertebrale, Malattia di Pott, Tubercolosi spinale
Portuguese Coluna vertebral com tuberculose, Mal de Pott, TB da coluna, Tuberculose da coluna vertebral, Tuberculose da medula espinhal, Tuberculose da coluna vertebral com exame NE, Doença de Pott, Tuberculose da Coluna Vertebral
Spanish Tuberculosis de la médula espinal, Tuberculosis espinal, Tuberculosis de la columna vertebral, TB de columna, Tuberculosis de columna, Tuberculosis de la columna vertebral, estudio no especificado, Tuberculosis Vertebral, Tuberculosis Espinal, Tuberculosis of spine, enfermedad de Pott, espondilitis tuberculosa - RETIRADO - (concepto no activo), espondilitis tuberculosa - RETIRADO -, espondilitis tuberculosa, tuberculosis de la columna vertebral (trastorno), tuberculosis de la columna vertebral, Enfermedad de Pott, Tuberculosis de la Columna Vertebral
Japanese 脊髄結核, 脊柱結核、検査の詳細不明, 脊柱結核, ｾｷﾁｭｳｹｯｶｸ, ｾｷﾁｭｳｹｯｶｸｹﾝｻﾉｼｮｳｻｲﾌﾒｲ, ｾｷﾂｲｹｯｶｸ, ﾎﾟｯﾄﾋﾞｮｳ, ｾｷｽﾞｲｹｯｶｸ, 結核-脊椎, Pott病, ポット病, 脊椎結核, 結核性脊椎炎, 脊椎カリエス, 脊椎炎-結核性
Swedish Tuberkulos, spinal
Czech tuberkulóza páteře, Tuberkulóza páteře, blíže neurčené vyšetření, Tuberkulózní zánět páteře, Tuberkulóza páteře, Pottova nemoc, TBC páteře, Tuberkulóza míchy
Finnish Selkärankatuberkuloosi
Russian TUBERKULEZ POZVONOCHNIKA, POTTA BOLEZN', POZVONOCHNIKA TUBERKULEZ, SPONDILIT TUBERKULEZNYI, ПОЗВОНОЧНИКА ТУБЕРКУЛЕЗ, ПОТТА БОЛЕЗНЬ, СПОНДИЛИТ ТУБЕРКУЛЕЗНЫЙ, ТУБЕРКУЛЕЗ ПОЗВОНОЧНИКА
Korean 척추의 결핵
Polish Gruźlica kręgosłupa, Choroba Potta
Hungarian Gerincoszlop tuberculosisa, gerinc tbc-s fertőzése, Gerincvelő tuberculosisa, gerinctuberculosis, Pott-betegség, Gerinc TBC, Gerincoszlop tuberculosisa, nem meghatározott vizsgálat
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Kyphosis deformity of spine (C0022821)

Definition (MSH) Deformities of the SPINE characterized by an exaggerated convexity of the vertebral column. The forward bending of the thoracic region usually is more than 40 degrees. This deformity sometimes is called round back or hunchback.
Definition (NCI) Abnormally increased curvature of the thoracic portion of the spine.
Definition (NCI) A disorder characterized by an abnormal increase in the curvature of the thoracic portion of the spine.
Concepts Anatomical Abnormality (T190)
MSH D007738
ICD10 M40.20
SnomedCT 88796005, 298383008, 414564002
English Kyphoses, Kyphosis, KYPHOSIS, Kyphosis, NOS, Angulation of spine, Kyphosis deformity of spine, Unspecified kyphosis, Kyphosis [Disease/Finding], gibbus, kyphosis, hunchback, round back, spine; angulation, angulation; spine, Gibbosity, Gibbus, Humpback, Hunchback, Kyphosis deformity of spine (disorder)
Japanese 脊柱後弯症, ｾｷﾁｭｳｺｳﾜﾝｼｮｳ
Swedish Kyfos
Spanish giba, cifosis, cifosis (trastorno), joroba, Kyphosis deformity of spine, deformidad de la columna vertebral - cifosis (trastorno), deformidad de la columna vertebral - cifosis, Cifosis
Czech kyfóza, Kyfóza
Finnish Kyfoosi
Russian KIFOZ, КИФОЗ
Croatian KIFOZA
Polish Wygięcie kręgosłupa tylne, Kifoza
Hungarian Kyphosis
Dutch angulatie; wervelkolom, wervelkolom; angulatie, kyfose, Kyfose
French Cyphose
German Kyphose
Italian Cifosi
Portuguese Cifose
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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