Tuberculous spondylitis - Pott disease - Diagnosis

Laboratory studies:Tuberculin skin-test positive in 95% of cases are HIV co-infectedErythrocyte-sedimentation rate may be moderately increased-Microbiological studies are used to confirm diagnosisObtain the tissue samples and bone colored-Bodies are isolated from culture-These studies are positive in 50% of cases.
Imaging Studies:Radiograph shows the relatively late changes:Lithic-destruction of the anterior portion of vertebral bodyEarlier-growth curveVertebral-body collapseMS-reactive to a progressive lithic-Enlarged psoas shadow with or without calcifications-Osteoporotic vertebral bodies areIntervertebral discs may be destroyed-Vertebral corpus shows varying degrees of destructionParavertebral spindle-shadow indicates the formation of an abscess-Bone lesions may occur at several levels.
Tomography scan and bone bring more irregular lithic lesions, sclerosis, disc collapse and destruction of bone circumference.Low-contrast resolution provides a better evaluation of epidural and paraspinale areas. CT scan shows lesion is early and make efficient for defining soft tissue abscesses calcifications.MRI is the criterion standard for evaluation of disc space infection and osteomyelitis of the spine. It is more effective in demonstrating soft tissue extension of disease and tuberculosis debriurilor along the anterior and posterior ligaments. It is the best method for demonstrating neural compression. Can differentiate tuberculous spondylitis of the piogenica.Percutaneous fine-needle aspiration of tuberculous abscesses and lesions to obtain tissue samples. It is a safe procedure that provides large paraspinale abscesses and drainage. Tissue samples are useful for microbiology and pathological studies to confirm the condition and to isolate and cultivate organisms.The differential diagnosis is made with the following conditions: actinomicoza, blastomycosis, brucellosis, candidiasis, histoplasmosis, metastases, miliary tuberculosis, multiple myeloma, nocardioza, septic arthritis, abscess of the spinal marrow.