Pott disease
From Wikipedia, the free encyclopedia
(Redirected fromPott's disease)Jump to:navigation, search
Tuberculosis of the spine in anEgyptianmummy
Pott disease
is a presentation of extrapulmonarytuberculosisthat affects the spine, a kindof tuberculous arthritis of the intervertebral joints. It is named after Percivall Pott(1714-1788), a London surgeon. Scientifically, it is called tuberculousspondylitisand it is mostcommonly localized in the thoracic portion of the spine.
Signs and symptoms
•
•
•
nightsweating
•
•
•
Spinal mass, sometimes associated withnumbness,tingling, or muscle weakness
of the legs
Diagnosis
•
•
•
radiographsof the spine
•
•
CTof the spine
•
•
Late complications
•
Vertebral collapse resulting inkyphosis
•
•
sinusformation
•
paraplegia(so called Pott's paraplegia)
Prevention
Controlling the spread of tuberculosis infection can prevent tuberculous spondylitis andarthritis. Patients who have a positivePPD test(but not active tuberculosis) may decreasetheir risk by properly taking medicines to prevent tuberculosis. To effectively treattuberculosis, it is crucial that patients take their medications exactly as prescribed.
Therapy
•
non-operative -antituberculous drugs
•
•
immobilization of the spine region by rod (Hull)
•
•
Richards intramedullary hip screw - facilitating for bone healing
•
Kuntcher Nail - intramedullary rod
•
Austin Moore - intrameduallary rod (for Hemiarthroplasty)
Pott's Disease (Spine)
Synonyms: Pott's syndrome, Pott's caries, Pott's curvature, angular kyphosis, kyphosis secondary to tuberculosis, tuberculosis of the spine, tuberculous spondylitis and David'sdisease
Description
Pott's disease is tuberculous caries or osteitis of the spinal column and must not beconfused with Pott's fracture of the ankle.The source of infection is usually outside the spine. It is most often spread from the lungsvia the blood. There is a combination of osteomyelitisand infective arthritis. Usuallymore than one vertebra is involved. The area most affected is the anterior part of thevertebral body adjacent to the subchondral plate.Tuberculosismay spread from that areato adjacent intervertebral discs. In adults, disc disease is secondary to the spread of
infection from the vertebral body but in children it can be a primary site, as the disc isvascular in children.It is the commonest place for tuberculosis to affect the skeletal system although it canaffect the hips and knees too. The usual sites to be involved are the lower thoracic andupper lumbar vertebrae.The infection spreads from two adjacent vertebrae into the adjoining disc space. If onlyone vertebra is affected, the disc is normal, but if two are involved the disc between themcollapses as it is avascular and cannot receive nutrients. Caseation occurs, with vertebralnarrowing and eventuallyvertebral collapseand spinal damage. A dry soft tissue massoften forms and superinfection is rare.
Epidemiology
•
Pott's disease is rare in the UK but in developing countries it represents about 2%of cases of tuberculosis and 40 to 50% of musculoskeletal tuberculosis.
•
Tuberculosis worldwide accounts for 1.7 billion infections, and 2 million deaths per year.
•
Over 90% of TB occurs in poorer countries, but a global resurgence is affectingricher ones.
•
India, China, Indonesia, Pakistan and Bangladesh have the largest number of cases but there has been a marked increase in the number of cases in the former Soviet Union and in sub-Saharan Africa in parallel with the spread of HIV.
•
The disease affects males more than females in a ratio of between 1.5 and 2:1. Inthe USA it affects mostly adults but in the countries where it is commonest itaffects mostly children.
Risk factors
•
•
Poor socio-economic conditions
•
Presentation
Symptoms
The onset is gradual.
•
Back painis localised
•
Fever
•
Night sweats
•
Anorexia
•
Weight loss
of 00
Pott Disease
5,162 Reads
Info and Rating
| Category: | Uncategorized. |
| Rating: | |
| Upload Date: | 08/24/2009 |
| Copyright: | Attribution Non-commercial |
| Tags: |
Leave a Comment