Meena Sanjay, Barwar Nilesh, Gupta Tusshar, Chowdhury Buddhadev
Department of Orthopaedics,All India Institute of Medical Sciences, Ansari Nagar,New Delhi1100029,India.
Oman Med J. 2014 Mar;29(2):e069. doi: 10.5001/omj.2014.40.
A 25-year-old male presented with complaints of abdominal pain for the past two months. He was prescribed Buscopan and omeprazole by a general surgeon. It was only when patient started complaining of backache that he was referred to an orthopedic surgeon. On examination of spine, there was tenderness at the upper dorsal spine. A diagnosis of Pott's disease affecting the upper dorsal spine was made. Magnetic resonance imaging (MRI) confirmed the vertebral changes and showed subligamentous spread of paravertebral masses from D2 to D7. This case illustrates the unusual form in which spine tuberculosis can present. High index of suspicion is necessary for early diagnosis and prompt management. General surgeons should be aware of this atypical presentation of Pott's disease.
一名25岁男性因过去两个月的腹痛症状前来就诊。普通外科医生给他开了消旋山莨菪碱和奥美拉唑。直到患者开始抱怨背痛时,他才被转诊至骨科医生处。检查脊柱时,发现上胸椎有压痛。诊断为累及上胸椎的波特氏病。磁共振成像(MRI)证实了椎体的变化,并显示椎旁肿块从D2至D7有韧带下扩散。该病例说明了脊柱结核可能出现的不寻常形式。早期诊断和及时治疗需要高度的怀疑指数。普通外科医生应意识到波特氏病的这种非典型表现。