Spectrum of Extrapulmonary Tuberculosis: Radiologic Manifestations

Binokay, F.; İnal, Mehmet; Bicakci, Kenon; Soyupak, Süreyya; Akgül, Erol; Oğuz, Mahmut

doi:10.1097/01.rad.0000088080.77991.0e

Cited by 2 publications

(3 citation statements)

References 17 publications

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“…15,29,33 Therefore, CT and MRI yielding positive findings in the early stage have become the radiologic modalities of choice in the diagnosis. 15,30 Destruction of vertebral body in our patients was found to be 90%, which was similar to the report by Alothman et al 26 The presence of paraspinal abscesses were noted in 75% of our patients, which is similar to the reported 73% to 90% rates. 8,9,24,26,29 An epidural involvement was only found in 37.5% of our patients, lower than other previously reported (53% to 80%).…”

Section: Discussionsupporting

confidence: 93%

“…14,15,20,22,23 Patients suspected to have spondylitis should undergo serology, blood and/or spinal specimen culture for Brucella species, where Brucellosis is common. 15,[28][29][30] In this series, evidence of accompanied extraskeletal involvement was found in 37.5% of cases, which was higher than others previously reported 27% to 29%. 14,23 Chest radiographs may generally show evidence of pulmonary disease in 50% of patients, but active pulmonary disease is present in less than 20%.…”

Section: Discussioncontrasting

confidence: 61%

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A Clinical Review of 40 Cases With Tuberculous Spondylitis in Adults

Taşova¹,

Sarpel

İnal³

et al. 2006

Neurosurgery Quarterly

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The purpose of this clinical review was to review clinical presentations, laboratory, and radiologic findings and difficulties on management of tuberculous spondylitis from a series of 40 cases. We carried out a retrospective analysis of 40 adult patients (50% male) with tuberculous spondylitis between January 1997 and December 2003. Infection was diagnosed in patients having a presentation compatible with characteristic histologic and/or microbiologic evidence of tuberculous spondylitis and diagnostic radiographic features, or following adequate response to antituberculous therapy with highly suggestive imaging features. Outcome was assessed according to clinical, radiologic, and laboratory criteria. Mean age was 44.7 ± 19 years. Thirty percent of patients had a history of contact with a patient having active pulmonary tuberculosis. The most frequent symptom and sign were back pain (92.5%) and, spinal tenderness (55%). Magnetic resonance imaging was found to be the most helpful technique for diagnosis. Lumbar spine was the most common affected region (82.5%). Thirty (75%) patients had paraspinal abscess and, 4 (10%) had concomitant sacroiliitis. Spinal biopsy had a yield of 76.5%, 52.9%, and 47% granulomas, positive culture, and acid-fast smear, respectively. Resistance to antituberculous drugs was 44.4%. Although medical treatment alone was given in 15% cases, 85% required additional surgical intervention. The mean duration of therapy was 12 ± 12 months. The improvement without sequela was 77.5% of the patients. In developing countries, diagnostic delay in tuberculous spondylitis is still common and disastrous. Bacteriologic confirmation and susceptibility testing should be achievable in all adult cases.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 61%

A Clinical Review of 40 Cases With Tuberculous Spondylitis in Adults

Taşova¹,

Sarpel

İnal³

et al. 2006

Neurosurgery Quarterly

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“…En 11 pacientes (91.7%) se halló la tríada radiológica característica de Phemister (osteopenia, osteolisis y disminución del espacio articular). 16 (Figura Nº 1) Además del tratamiento farmacológico, todos estos pacientes requirieron en un principio desbridamiento y uno o más lavados. Tres de los cinco pacientes con compromiso de la cadera requirieron protección para disminuir el riesgo de fractura; de estos, en dos que eran menores de 12 años se usó el yeso pelvipédico y en el adulto, una ortosis de apoyo isquiático.…”

Section: Tb Osteoarticular Extraespinal Tb Osteoarticular Extraespina...unclassified

Perfiles epidemiológico y clínico de la tuberculosis osteoarticular: estudio observacional en el Hospital Universitario San Vicente de Paúl, de Medellín, 1994-2004

Córdoba

Henao

Ríos

et al. 2005

Iatreia

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Se llevó a cabo un estudio observacional retrospectivo en el Hospital Universitario San Vicente de Paúl, de Medellín, basado en la revisión de las historias de pacientes con tuberculosis osteoarticular, entre enero de 1994 y diciembre de 2004; con base en los hallazgos se describen las características demográficas, clínicas, de laboratorio y de tratamiento de 47 pacientes que correspondían al 3.2% del total de casos de tuberculosis hallados en la década estudiada; 35 tuvieron tuberculosis de la columna vertebral y en 12 la enfermedad fue extraespinal; solo en 7 pacientes se halló el antecedente de tuberculosis pulmonar; 23 eran mujeres y 24, hombres, con edades entre 1 y 71 años; 18 eran menores de 12 años; los cultivos para Mycobacterium tuberculosis fueron positivos en 14 pacientes (29.8%) y las biopsias fueron compatibles con tuberculosis en 26 pacientes (55.3%); 11 de los 12 pacientes con tuberculosis extraespinal presentaban la tríada radiológica de Phemisther, constituida por osteopenia, osteolisis y disminución del espacio articular. Los síntomas predominantes en los pacientes con tuberculosis espinal fueron: dolor, síntomas neurológicos y deformidad, principalmente cifosis; radiológicamente estos pacientes tenían destrucción de cuerpos vertebrales y disminución del espacio articular, además de osteopenia. La tomografía se hizo en 19 pacientes y mostró compresión medular en 5; la resonancia magnética practicada a 17 pacientes reveló absceso paravertebral en todos ellos y compresión medular en 8. Se discuten los hallazgos a la luz de la información hallada en la literatura médica mundial y en el contexto de la situación de salud de la población colombiana.

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Spectrum of Extrapulmonary Tuberculosis: Radiologic Manifestations

Abstract: Extrapulmonary tuberculosis mostly affects musculoskeletal, genitourinary, gastrointestinal, and central nervous systems.

Cited by 2 publications

References 17 publications

A Clinical Review of 40 Cases With Tuberculous Spondylitis in Adults

A Clinical Review of 40 Cases With Tuberculous Spondylitis in Adults

Perfiles epidemiológico y clínico de la tuberculosis osteoarticular: estudio observacional en el Hospital Universitario San Vicente de Paúl, de Medellín, 1994-2004

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