Pott's Disease in Tuberculosis - Diagnosis and Management Summary Epidemiology: - Typically from TB endemic areas - 1-5% of patients with TB - 10% of extrapulmonary cases Clinical Signs/Symptoms: - Insidious, progressive back pain - Symptoms may range from a few months to several years - May have signs/symptoms of active pulmonary TB PE: - Local pain at thoracic/lumbar segment - "Gibbus deformity" - Assess for weakness, pain, numbness, decreased reflexes Pathophysiology: - Mycobacterium tuberculosis complex - Spread of bacilli to bone/joints via hematogenous dissemination Diagnosis: - MRI is modality of choice to visualize soft tissue damage - CXR should be done in ALL patients to assess for concomitant pulmonary involvement - CT guided needle aspiration or excisional biopsy - Detection of AFB by smear microscopy Management: - Initial intensive RIPE therapy for 2 month - Continuation phase with Isoniazid and Rifampin for 4-7 months +/- Surgical intervention CMC IM Residency @CMC_IM #Potts #Disease #Tuberculosis #TB #Diagnosis #Management #Summary
