RARE
PRESENTATION OF SPINAL TUBERCULOSIS IN PAEDIATRIC AGE GROUP
Dr. AMOL BITEY,Dr. (Mrs.) P. S.
PENDHARKAR, Prof. & Head,Dr. (Mrs.) B. D. SONAWANE, Asso.
Prof.
Dr. S. Z. SORTE, Asso. Prof.,Dr. R. R. KHANDELWAL, Hon. Asso.
Prof.,Dr. SURESH PHATAK, Hon. Asso. Prof.
Dr. DHANASHREE DANDE, Asst. Lect. DEPT. OF RADIOLOGY, INDIRA
GANDHI MEDICAL COLLEGE, NAGPUR.
SPINAL TUBERCULOSIS
Vertebral tuberculosis is commonest of
skeletal tuberculosis. It accounts for 50 % of all cases of
tuberculosis of Bones & Joints.
AGE & SEX :
Commonest: 3rd Decade
Equal in Both Sexes
SYMPTOMS & SIGNS :
Constitutional symptoms.
Painful movements
Kyphotic deformities
Parspinal abscesses or sinuses.
PATHOPHYSIOLOGY :
Association with primary focus in the
viscera can be detected only in 12 to 50 % cases.
Hematogenous spread
30 - 40 % Bone loss should occur to be
visualised radiologically as osteolytic lesion.
REGIONAL DISTRIBUTION :
Cervical Spine: more common in
childhood age group.
Commonest sites: lower thoracic &
thoracolumbar.
TYPES :
METAPHYSEAL : Common in adults
Earliest feature is decrease of
disc space and end plate involvement.
CENTRAL :
Common in paediatric age group.
Route of infection: Batson's venous
plexus or posterior vertebral artery.
Central osteolytic lesion in the
vertebral body.
Disc space maintained
Concentric collapse occur (D/D Calve's
Disease)
ANTERIOR :
Infection starts beneath anterior
longitudinal ligament & periosteum.
Vertebra is eroded from anterior end .
Disc spaces are maintained.
Common in thoracic spine.
Childhood Age group is most commonly
affected.
POSTERIOR ELEMENTS TYPE :
Very rare
Involves pedicles, transverse process,
laminae, spinous processes.
Intervertebral disc spaces maintained
Early detection CT scan / MRI
SYNOVITIS TYPE :
Atlanto - occipital
Atlanto-axial
Costo - vertebral
Junction of superior and inferior
articular processes.
CASE:
NAME : Sonali
AGE : 10 yrs Female
CHIEF COMPLAINTS : Low backache,
Limping gait since 1 month
RADIOGRAPHIC PRESENTATION :
FILM1
FILM2
A well defined central osteolytic
lesion at the body of L3 vertebra .
No sclerosis.
Partial collapse of L3 vertebra.
Maintained disc spaces.
Slight scoliosis towards left.
USG Findings :
Right Psoas collection 350 cc
LABORATORY INVESTIGATIONS :
Serum IgG for Kochs : 370 units/ml.
