| Tuberculous spondylitis in elderly Japanese patients. | |
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MedLine Citation:
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PMID: 18274850 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Although the number of patients with tuberculous spondylitis in Japan is increasing slowly, the proportion of the elderly among these patients is increasing more quickly. The purpose of this study was to describe the clinical features and diagnostic imaging findings in elderly tuberculous spondylitis patients in order to enhance diagnosis of the condition in the elderly population. METHODS: We conducted a retrospective review of 23 patients over 70 years of age previously diagnosed with tuberculous spondylitis. Clinical signs and symptoms, including local pain, fever, and neurological deficits, were analyzed. Routine laboratory tests, including the erythrocyte sedimentation rate, the white blood cell count, and the C-reactive protein level were also reviewed. The results of plain X-rays and magnetic resonance imaging were studied. RESULTS: Patients' signs and symptoms were as follows: local pain in 19 patients (83%); fever in 7 patients (30%) and no fever in 16 patients (70%); and neurological deficits in 13 patients (57%). C-Reactive protein was less than 1.0 mg/dl in 6 patients (26%). Radiography revealed several changes in the affected vertebrae; 3 patients had atypical changes involving only a single vertebra. CONCLUSIONS: It is difficult to diagnose tuberculous spondylitis in the elderly because there are atypical symptoms, a scarcity of inflammatory changes, and degenerative changes normally seen in the elderly may mask the radiographic changes due to tuberculous spondylitis. Tuberculous spondylitis should be considered a possibility in the differential diagnosis of back pain in the elderly, especially in countries with a significant history of tuberculosis in the population. |
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Authors:
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Yuki Maeda; Kazutaka Izawa; Takaharu Nabeshima; Kazuo Yonenobu |
Publication Detail:
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Type: Journal Article Date: 2008-02-16 |
Journal Detail:
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Title: Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association Volume: 13 ISSN: 0949-2658 ISO Abbreviation: J Orthop Sci Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-02-15 Completed Date: 2008-05-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9604934 Medline TA: J Orthop Sci Country: Japan |
Other Details:
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Languages: eng Pagination: 16-20 Citation Subset: IM |
Affiliation:
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Department of Orthopaedic Surgery, Osaka Minami Medical Center, Kawachinagano, Osaka, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Antitubercular Agents / therapeutic use Cohort Studies Female Humans Japan Male Orthopedic Procedures Osteolysis / diagnosis, microbiology, therapy Retrospective Studies Spondylitis / diagnosis*, microbiology* Tuberculosis, Spinal / complications, diagnosis*, therapy |
| Chemical | |
Reg. No./Substance:
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0/Antitubercular Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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