Document Detail


Tuberculous spondylitis in elderly Japanese patients.
MedLine Citation:
PMID:  18274850     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Yuki Maeda; Kazutaka Izawa; Takaharu Nabeshima; Kazuo Yonenobu
Publication Detail:
Type:  Journal Article     Date:  2008-02-16
Journal Detail:
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:
Created Date:  2008-02-15     Completed Date:  2008-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9604934     Medline TA:  J Orthop Sci     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  16-20     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Osaka Minami Medical Center, Kawachinagano, Osaka, Japan.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Antitubercular Agents

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