How is spinal tuberculosis diagnosed?

summary

Bone and joint tuberculosis is a secondary disease, can eat some light things, 95% secondary to pulmonary tuberculosis, a few secondary to gastrointestinal tuberculosis, pleural tuberculosis or lymph node tuberculosis. It can occur in the active stage of the primary lesion, or after the primary lesion is still for many years. So how to diagnose spinal tuberculosis? I hope this problem can help some people.

How is spinal tuberculosis diagnosed?

The main manifestations of X-ray are: 1. Change of physiological radian (angular deformity); 2; 2. The shape of vertebral body changed, even cavity and dead bone formed; 3. Narrowing or disappearance of intervertebral space (one of the X-ray features of vertebrobasilar junction), but adult centroid type can also keep normal intervertebral space for a long time; 4. Vertebral body destruction, compression, wedging central type; 5. Narrowing of intervertebral space - marginal type; 6. Paravertebral abscess - paravertebral soft tissue shadow can be seen, which can be spherical, fusiform or tubular, and generally asymmetric.

Second, CT and MRI showed that most patients with spinal tuberculosis could see cold nodules, psoas major abscess and paravertebral abscess on CT, with uneven density, small dead bone, calcification and sclerotic ring necrosis shadow, and a few patients could have anterior cervical soft tissue abscess.

Third, laboratory examination showed mild anemia; The white blood cell count was normal; ESR can be increased in the active stage of tuberculosis, which is an important index. Simple abscess can be used as sediment to find acid fast bacilli, or tubercle bacillus culture; X-ray examination: positive findings were found two months after onset, dead bone and abscess could be found by CT, abnormal signal could be found by MRI in the stage of bacterial infiltration, and the situation of spinal cord could be observed. B ultrasound can detect the location and size of abscess. Arthroscopy and synovial biopsy are valuable in diagnosis.

matters needing attention

Central type is more common in children. The focus starts from the center of vertebral cancellous bone, and there are often dead bone and cavity formation. Due to the small vertebral body, the disease progresses quickly, and it is easy to invade the whole vertebral body and intervertebral disc. In adults, large lesions of vertebral body progress slowly; If there is no disc narrowing, it should be differentiated from vertebral tumor.