Korean J Pain.  2010 Mar;23(1):74-77.

Post-traumatic Back Pain Revealed as Tuberculous Spondylitis: A Case Report

• Kim BS
• Shin JH
• Moon HS
• Chon JY
• Sung CH

Abstract

Tuberculous spondylitis is a very rare disease, but it can result in bone destruction, kyphotic deformity, spinal instability, and neurologic complications unless early diagnosis and proper management are done. Because the most common symptom of tuberculous spondylitis is back pain, it can often be misdiagnosed. Atypical tuberculous spondylitis can be presented as a metastatic cancer or a primary vertebral tumor. We must make a differential diagnosis through adequate biopsy. A 30-year-old man visited our clinic due to back and chest pain after a recent traffic accident. About 1 year ago, he had successfully recovered from tuberculous pleurisy after taking anti-tuberculosis medication. We performed epidural and intercostal blocks but the pain was not relieved. For the further evaluation, several imaging and laboratory tests were done. Finally, we confirmed tuberculous spondylitis diagnosis with the biopsy results.

Keyword

back pain; biopsy; differential diagnosis; tuberculous spondylitis

MeSH Terms

Accidents, Traffic
Adult
Back Pain
Biopsy
Chest Pain
Diagnosis, Differential
Early Diagnosis
Humans
Rare Diseases
Spondylitis
Tuberculosis, Spinal
Tuberculosis, Pleural

Figure

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  Fig. 1 Lateral view of T-spine shows no specific bony abnormalities.

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  Fig. 2 Sagittal T2-weighted MR imaging shows a heterogeneous high signal lesion at T9 body.

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  Fig. 3 Axial view of CT shows trabecular thickening and tubular defect at T9 body. Bone density is heterogeneously decreased.

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  Fig. 4 Microphotogram shows a chronic granulomatous inflammation with caseous necrosis (white arrow) and multinucleated giant cells (black arrow) (Hematoxylin and Eosin stain, ×200).

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