Pott’s Disease
A 45-year-old man presents with a 6-month history of progressive back pain, fatigue, and weight loss. He reports that the pain started as mild discomfort in his lower back but has gradually worsened, becoming constant and severe, especially at night. Over the past few weeks, he has also noticed weakness in his legs and difficulty walking. There is no history of trauma, but he mentions a chronic cough he experienced several months ago, which resolved without treatment.
On physical examination, there is tenderness over the lower thoracic spine, and a mild kyphotic deformity is noted. Neurological examination reveals decreased strength in both legs and reduced sensation below the level of the mid-thoracic spine. An X-ray of the spine shows vertebral collapse and narrowing of the intervertebral spaces, while an MRI reveals abscess formation around the affected vertebrae. A subsequent TB skin test is positive.
He is diagnosed with Pott’s disease (tuberculous spondylitis), a form of spinal tuberculosis. The treatment plan includes a combination of anti-tuberculosis medications for an extended period and possible surgical intervention to stabilize the spine if neurological symptoms worsen or abscess drainage is required.
a). Severe neck pain
b). Progressive back pain
c). Chest pain
d). Headache and fever
a). Weight loss
b). Difficulty walking and leg weakness
c). Chronic cough
d). Night sweats
a). CT scan
b). X-ray and MRI
c). Ultrasound
d). Bone scan
a). Anti-tuberculosis medications and possible surgical intervention
b). Physical therapy and pain management
c). Corticosteroids and bed rest
d). Antibiotics for 1 week followed by surgery
