Pott's disease differential diagnosis: Difference between revisions

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__NOTOC__
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{{Pott's disease}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Pott%27s_disease]]
{{CMG}}; {{AE}} {{HP}}
{{CMG}}; {{AE}} {{HP}}; {{AKI}}
 
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==Overview==
==Overview==
Pott's disease resembles [[spinal tumor]]s, spinal cord [[abscess]], [[Mycobacterium kansasii]], [[nocardiosis]], [[septic arthritis]], [[metastatic cancer]], [[multiple myeloma]], [[miliary tuberculosis]], spinal [[fungal infection]]s, and [[Mycobacterium avium-intracellulare]] and needs to be differentiated from them.
Pott's disease resembles [[spinal tumor]]s, spinal cord [[abscess]], [[septic arthritis]], [[metastatic cancer]], [[multiple myeloma]], [[miliary tuberculosis]]. Therefore it must be differentiated from them.


==Differentiating Pott's Disease from other Diseases==
==Differentiating Pott's Disease from other Diseases==
Pott's disease resembles the following disorders and needs to be differentiated from them:
[[Pott's disease]] presents with features of [[back pain]] and [[myelopathy]] and must be differentiated from the following:
{| class="wikitable"
!Disease
!Age of Presentation
!Common site involved
!Risk Factors
!Clinical Features
!Laboratory Findings
!Imaging Findings
|-
|[[Pyogenic abscess]] of the [[spine]]
|Any age
|[[Lumbar spine]]
|[[Diabetes mellitus]]
|
*[[Fever]]
*[[Back pain]]
*[[Myelopathy]]
|
*Elevated [[ESR]]
*Elevated [[WBC]]'s
*Elevated [[CRP]]
|
*Destruction of [[vertebra|vertebral]] bodies and disc spaces
*Enhancement of the lesion
*[[Epidural abscess]]
|-
|[[Pott's Disease]]
|Children and adults
|
*Upper [[Lumbar spine]]
*Lower [[Thoracic spine]]
|Exposure to [[tuberculous infection]]
|
*[[Fever]]
*[[Malaise]]
*[[Weight loss]]
*[[Backache]]
*[[Myelopathy]]
|
*Elevated [[ESR]]
*Normal [[WBC]]
|
*Destruction of vertebral bodies and disc spaces
*Rim enhancement of the soft-tissue masses
|-
|[[Brucella]] [[abscess]] of the spine
|Adults
|[[Lumbar spine]]
|Ingestion of unpasteurized milk
|
*[[Fever]]
*[[Malaise]]
*[[Weight loss]]
*[[Backache]]
|
*Elevated [[ESR]]
*Elevated [[WBC]]
*Elevated [[CRP]]
|
*Intact vertebral architecture even in the presence of diffuse vertebral [[osteomyelitis]]
|-
|Vertebral [[Metastasis]]
|Elderly
|[[Thoracic spine]]
|Presence of systemic [[malignancy]]
|
*[[Bone pain]] at night
*[[Backache]]
*[[Radicular pain]]
*[[Myelopathy]]
|
*Normal [[WBC]]
*Normal [[ESR]]
*Normal [[CRP]]
|
*Low signal intensity on T1-weighted images
*Hypersignal on T2-weighted
*Heterogeneous enhancement
|}
<small>Table adopted from Spinal Tuberculosis: A Review<ref name="pmid22118251">{{cite journal| author=Garg RK, Somvanshi DS| title=Spinal tuberculosis: a review. | journal=J Spinal Cord Med | year= 2011 | volume= 34 | issue= 5 | pages= 440-54 | pmid=22118251 | doi=10.1179/2045772311Y.0000000023 | pmc=3184481 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22118251  }} </ref></small><br>
 
Additional differential diagnosis to be considered include:
*[[Spinal tumor]]s
*[[Spinal tumor]]s
*Spinal cord [[abscess]]
*Spinal cord [[abscess]]
*[[Mycobacterium kansasii]]
*[[Nocardiosis]]
*[[Paracoccidioidomycosis]]
*[[Septic arthritis]]
*[[Septic arthritis]]
*[[Metastatic cancer]]<ref name="pmid27559455">{{cite journal| author=Mittal S, Khalid M, Sabir AB, Khalid S| title=Comparison of Magnetic Resonance Imaging Findings between Pathologically Proven Cases of Atypical Tubercular Spine and Tumour Metastasis: A Retrospective Study in 40 Patients. | journal=Asian Spine J | year= 2016 | volume= 10 | issue= 4 | pages= 734-43 | pmid=27559455 | doi=10.4184/asj.2016.10.4.734 | pmc=4995258 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27559455  }} </ref>
*[[Metastatic cancer]]<ref name="pmid27559455">{{cite journal| author=Mittal S, Khalid M, Sabir AB, Khalid S| title=Comparison of Magnetic Resonance Imaging Findings between Pathologically Proven Cases of Atypical Tubercular Spine and Tumour Metastasis: A Retrospective Study in 40 Patients. | journal=Asian Spine J | year= 2016 | volume= 10 | issue= 4 | pages= 734-43 | pmid=27559455 | doi=10.4184/asj.2016.10.4.734 | pmc=4995258 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27559455  }} </ref>
*[[Multiple myeloma]]
*[[Multiple myeloma]]
*[[Miliary tuberculosis]]
*[[Miliary tuberculosis]]
*[[Actinomycosis]]
*[[Blastomycosis]]
*[[Brucellosis]]
*[[Candidiasis]]
*[[Cryptococcosis]]
*[[Histoplasmosis]]
*[[Mycobacterium avium-intracellulare]]


==References==
==References==
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[[Category:Vertebral column disorders]]
[[Category:Vertebral column disorders]]
[[Category:Tuberculosis]]
[[Category:Tuberculosis]]
[[Category:Infectious disease]]
 
[[Category:Disease]]
[[Category:Disease]]
{{WH}}
{{WH}}
{{WS}}
{{WS}}

Latest revision as of 20:03, 8 April 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hardik Patel, M.D.; Aravind Kuchkuntla, M.B.B.S[2]

Overview

Pott's disease resembles spinal tumors, spinal cord abscess, septic arthritis, metastatic cancer, multiple myeloma, miliary tuberculosis. Therefore it must be differentiated from them.

Differentiating Pott's Disease from other Diseases

Pott's disease presents with features of back pain and myelopathy and must be differentiated from the following:

Disease Age of Presentation Common site involved Risk Factors Clinical Features Laboratory Findings Imaging Findings
Pyogenic abscess of the spine Any age Lumbar spine Diabetes mellitus
Pott's Disease Children and adults Exposure to tuberculous infection
  • Destruction of vertebral bodies and disc spaces
  • Rim enhancement of the soft-tissue masses
Brucella abscess of the spine Adults Lumbar spine Ingestion of unpasteurized milk
  • Intact vertebral architecture even in the presence of diffuse vertebral osteomyelitis
Vertebral Metastasis Elderly Thoracic spine Presence of systemic malignancy
  • Low signal intensity on T1-weighted images
  • Hypersignal on T2-weighted
  • Heterogeneous enhancement

Table adopted from Spinal Tuberculosis: A Review[1]

Additional differential diagnosis to be considered include:

References

  1. Garg RK, Somvanshi DS (2011). "Spinal tuberculosis: a review". J Spinal Cord Med. 34 (5): 440–54. doi:10.1179/2045772311Y.0000000023. PMC 3184481. PMID 22118251.
  2. Mittal S, Khalid M, Sabir AB, Khalid S (2016). "Comparison of Magnetic Resonance Imaging Findings between Pathologically Proven Cases of Atypical Tubercular Spine and Tumour Metastasis: A Retrospective Study in 40 Patients". Asian Spine J. 10 (4): 734–43. doi:10.4184/asj.2016.10.4.734. PMC 4995258. PMID 27559455.

Template:WH Template:WS