Pott's Disease: Difference between revisions
No edit summary |
No edit summary |
||
| Line 12: | Line 12: | ||
== '''<br>'''<u>Incidence<br></u>In 2005, there were 8.8 million new patients with tuberculosis (TB) all over the world, and of these, there were 7.4 million in Asia and sub-Saharan Africa (5). Involvement of the spine reportedly occurs in less than 1-2% of patients who contracted TB. Although the incidence of tuberculosis increased in the late 1980’s to early 1990’s, the total number of cases has decreased in recent years. In the United States, bone and soft tissue tuberculosis accounts for approximately 10% of extrapulmonary TB cases and between 1% and 2% of total cases. Of these cases, Pott’s disease is the most common manifestation of musculoskeletal TB, accounting for approximately 40-50% (3). Internationally, approximately 1-2% of total tuberculosis cases are attributable to Pott’s disease. == | == '''<br>'''<u>Incidence<br></u>In 2005, there were 8.8 million new patients with tuberculosis (TB) all over the world, and of these, there were 7.4 million in Asia and sub-Saharan Africa (5). Involvement of the spine reportedly occurs in less than 1-2% of patients who contracted TB. Although the incidence of tuberculosis increased in the late 1980’s to early 1990’s, the total number of cases has decreased in recent years. In the United States, bone and soft tissue tuberculosis accounts for approximately 10% of extrapulmonary TB cases and between 1% and 2% of total cases. Of these cases, Pott’s disease is the most common manifestation of musculoskeletal TB, accounting for approximately 40-50% (3). Internationally, approximately 1-2% of total tuberculosis cases are attributable to Pott’s disease. == | ||
== | == == | ||
== <br><u>Age<br></u>In the United States and other developed countries, Pott’s disease occurs primarily in adults. In underdeveloped countries which have higher rates of Pott’s disease, involvement in young adults and older children predominates (3).<br> == | == <br><u>Age<br></u>In the United States and other developed countries, Pott’s disease occurs primarily in adults. In underdeveloped countries which have higher rates of Pott’s disease, involvement in young adults and older children predominates (3).<br> == | ||
Revision as of 21:46, 30 March 2012
Original Editors - David Pieschel & Craig Satterley from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Definition/Description[edit | edit source]
add text here
Prevalence[edit | edit source]
Incidence
In 2005, there were 8.8 million new patients with tuberculosis (TB) all over the world, and of these, there were 7.4 million in Asia and sub-Saharan Africa (5). Involvement of the spine reportedly occurs in less than 1-2% of patients who contracted TB. Although the incidence of tuberculosis increased in the late 1980’s to early 1990’s, the total number of cases has decreased in recent years. In the United States, bone and soft tissue tuberculosis accounts for approximately 10% of extrapulmonary TB cases and between 1% and 2% of total cases. Of these cases, Pott’s disease is the most common manifestation of musculoskeletal TB, accounting for approximately 40-50% (3). Internationally, approximately 1-2% of total tuberculosis cases are attributable to Pott’s disease.[edit | edit source]
[edit | edit source]
Age
In the United States and other developed countries, Pott’s disease occurs primarily in adults. In underdeveloped countries which have higher rates of Pott’s disease, involvement in young adults and older children predominates (3).
[edit | edit source]
Characteristics/Clinical Presentation[edit | edit source]
Signs and Symptoms
• Back Pain: Back pain is the earliest and most common symptom. Patients with Pott’s disease usually experience back pain for weeks before seeking treatment and the pain caused by spinal TB can present as spinal or radicular. Although both the thoracic and lumbar spinal segments are nearly equally affected, the thoracic spine is frequently reported as the most common site of involvement. Together, thoracic and lumbar involvement comprise of 80-90% of spinal TB sites(3).
• Neurological signs: Neurologic abnormalities occur in 50% of cases and can include spinal cord compression with paraplegia, paresis, impaired sensation, nerve root pain and/or cauda equina syndrome(3).
• Spinal Deformities: Almost all patients with Pott’s disease have some degree of spine deformity with thoracic kyphosis being the most common (3).
• Constitutional Symptoms: Potential constitutional symptoms include fever, weight loss and malaise(7).
• Cervical Spinal TB: Cervical spine TB is a less common presentation occurring in approximately 10% of cases, but is potentially more serious because severe neurological complications are more likely. This condition is characterized by cervical pain and stiffness and symptoms can also include torticollis, hoarseness, and neurological deficits. Upper cervical spine involvement can cause rapidly progressive symptoms and neurologic manifestations occur early and range from a single nerve palsy to hemiparesis or quadriplegia. Retropharyngeal abscesses occur in almost all cases. In lower cervical spine insults, the patient can present with dysphagia or stridor(3).
• Presentation in People Infected with HIV: The clinical presentation of spinal tuberculosis in patients infected with the human immunodeficiency virus (HIV) is similar to that of patients who are HIV negative; however, spinal TB seems to be more common in persons infected with HIV(3).
• Many persons with Pott’s disease (62-90%) of patients reported series have no evidence of extraspinal tuberculosis, further complicating a timely diagnosis.(3)
Associated Co-morbidities[edit | edit source]
add text here
Medications[edit | edit source]
add text here
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
add text here
Etiology/Causes[edit | edit source]
add text here
Systemic Involvement[edit | edit source]
add text here
Medical Management (current best evidence)[edit | edit source]
add text here
Physical Therapy Management (current best evidence)[edit | edit source]
add text here
Alternative/Holistic Management (current best evidence)[edit | edit source]
add text here
Differential Diagnosis[edit | edit source]
add text here
Case Reports/ Case Studies[edit | edit source]
add links to case studies here (case studies should be added on new pages using the case study template)
Resources
[edit | edit source]
add appropriate resources here
Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
Failed to load RSS feed from http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1NGmwZeh8JwVIzrKgHG1LrDm0izTr7ViJiDkSYAY2BW5hiXsx0|charset=UTF-8|short|max=10: Error parsing XML for RSS
References[edit | edit source]
see adding references tutorial.
