Question of the Week

Question :
Posted On : 29 Oct 2009
We have a patient admitted, 12 yrs old male child was seen in OPD for back pain of 1 month, he also had restriction of spine movements
no hpero feverpertraumaperTBperTBCperweight lossperjoint pains
other physical examination normal with no local tenderness

He was investigated:
X ray spine and pelvis showed sclerosis of bil sacroiliac joint. We considered it as _?Juvenile Ank Sponds and was investigated further but
his test for HLA B27 and ANA, RA were negative.

His MRI spine and pelvis was done, suggestive of wedge collapse of L3 vertebra with prevertebral and Rt paravertebral hyperintensities suggestive of Tuberculous osteomyelitis.
His MRI pelvis suggestive of _?Ankylosing spondylitis.
Ptient is presently on AKT and strict bed rest.

My query is- is sclerosis of bil sacroiliac joint related to Tuberculosis or its a diffrent entity. What could be the differential for the same
5
Expert Answer :
Tuberculous sacroiliac joint involvement can occur. The sacroiliac joint may be secondarily involved following a psoas abscess affecting the lower lumbar spine. The natural history of sacroiliac tuberculosis is bony ankylosis. CT scans revealed joint space widening, sclerosis of the joint margins and sequestra within the joint
Answer Discussion :
R
richa sharma
Profile
ankylosing tuberclulosis of sacroiliac joint
15 years ago
G
George Paul
Profile
TB spine
15 years ago
A
Anay Deshmukh
Profile
Probably yes! Its a part of TB spectrum As it is rightly said that TB can present with anything and everything on earth {and esp.ly in India} except pregnancy. And secondly, if the diagnosis of TB has been confirmed , then one should not think of two different diagnoses for one pathological entity.
15 years ago
F
Faizan Bhoira
Profile
TB may be the cause
15 years ago
P
palanisamy ayyappan
Profile
ank spondi
15 years ago




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