Spine
A 34-year-old male patient is visiting from out of the country and presents to the emergency department with a 3-month history of upper middle back pain, a dry cough, and unintended weight loss. Laboratory test results show a normal serum white blood-cell count. A chest radiograph shows a consolidation in the upper zone of the left lung with ipsilateral hilar enlargement suspicious for a tuberculous nodule. Which of the following radiographic characteristics helps distinguish tuberculous from pyogenic spinal infections?
Remediation:
A. Pott's disease was a common cause of acquired spinal kyphosis as TB tends to affect the anterior aspect of the spine, which leads to bony collapse and kyphosis.
B. This is a consistent feature of a tuberculous spine compared with pyogenic spinal infection.
C. Prior spinal surgery is a risk for pyogenic, not tuberculous, spinal infections. A TB spine comes from hematogenous spread of primary pulmonary TB.
D. Anterior column involvement is common for TB. Osteolysis and collapse leads to kyphosis.