Discusses history, physical examination & investigation modalities useful in diagnosing tb of spine and important findings

1. By Jagjit Khosla

2. History
Examination
Investigation
Diagnosis

4. Back Pain
Stiffness
Swelling at back
Paraplegia
Deformity
1
2
3
4
5

5. Constitutional symptoms6
Evening rise of temp Night sweats Weight loss and
anorexia
+ Previous history of Pulmonary TB or Contact history

6. Congenital
Traumatic
Inflammatory
Neoplastic
Degenerative
Metabolic

7.  Not since birth
 No H/o Trauma/Lifting weight or
strenuous exercises preceding pain
 No other bone or joint problems
 Non radiating pain
 No Morning stiffness
 No H/o Haematuria, dysurea, oliguria
 No H/o Menstrual problems
Congenital
Traumatic/
Prolapsed disc
Neoplastic
Prolapsed disc
Ankylosing spondylitis
Genito-urinary
Gynaecological

9. • Kyphotic deformity

10. Spinal movements
restricted
Paravertebral
swelling

11.  Straight Leg raising test
 Cough impulse over swelling
Prolapsed disc
Meningocele
(spina bifida)

13. • X-RAY – AP and Lateral view
• MRI
• C.T. Scan
• Myelography
• Biopsy
• Ix for Primary focus – Chest X-ray, X-ray KUB
• General Investigations

16. 1

17. 2

18. 3

19. 3

20. 4
Retropharyngeal
abscess

21. 4
Widened
mediastinum

22. 4
Para vertebral
Fusiform abscess

23. 4
Psoas abscess

24. 1
2
3

25. 1 2

26. • Myelography – Level of nerve lesion
• Biopsy - Etiology
• Chest X-ray
• X-ray KUB
• General Investigations –
– ESR, Mantoux, ELISA
Primary focus of TB