Asian Spine J.  2013 Dec;7(4):351-354. 10.4184/asj.2013.7.4.351.

Isolated Tuberculosis of Sacrum with Monoparesis: An Atypical Presentation

• Sament R
• Bachhal V
• Gopinathan NR
• Sen RK

• KMID: 2270418
• DOI: http://doi.org/10.4184/asj.2013.7.4.351

Abstract

Tuberculosis is a major health problem in developing nations. Spine is the most commonly affected site for skeletal tuberculosis but involvement of sacrum is rare. Isolated involvement of sacrum has been reported in literature but none of the reports has mentioned its clinical presentation as monoparesis. Our case presented with symptoms of sensory and motor deficit in right lower limb. The magnetic resonance imaging spine and non contrast computerized tomogram revealed a sacral lesion but were inconclusive of diagnosis. Histological examination after computed tomography guided biopsy revealed the condition as tuberculosis. Anti tubercular treatment was started after confirmation of diagnosis and continued for 18 months. Erythrocyte sedimentation rate and C-reactive protein drooped to normal range and patient was symptom free at two-year follow up. This case report intends to emphasize that sacral tuberculosis, being itself a rare condition, may present atypically as monoparesis.

Keyword

Tuberculosis; Sacroiliac joint; Antibiotics; Monoparesis

MeSH Terms

Anti-Bacterial Agents
Biopsy
Blood Sedimentation
C-Reactive Protein
Developing Countries
Diagnosis
Follow-Up Studies
Humans
Lower Extremity
Magnetic Resonance Imaging
Paresis*
Reference Values
Sacroiliac Joint
Sacrum*
Spine
Tuberculosis*
Anti-Bacterial Agents
C-Reactive Protein