Glynn M J, Duckworth G, Ridge J A, Grange W J, Gibbs D D
Royal London Hospital, Whitechapel.
Br J Rheumatol. 1994 Nov;33(11):1085-6. doi: 10.1093/rheumatology/33.11.1085.
Tuberculous spondylitis is a well-recognized cause of back pain and vertebral collapse due to infection and with must not be overlooked even if it is not the most likely diagnosis. If a patient, particularly one of Asian origin, were to present with a solitary destructive bone lesion, without evidence of myeloma or other malignancy, a trial of anti-tuberculous chemotherapy would be one therapeutic approach, even if there was no evidence of tuberculosis elsewhere. However, failure to biopsy the bone lesion and undertake the appropriate microbiology could lead to other important diagnoses being missed. This is illustrated by the case which we report below.
结核性脊柱炎是因感染导致背痛和椎体塌陷的一种公认病因，即便它并非最可能的诊断，也绝不能被忽视。如果患者，尤其是亚裔患者，出现孤立性骨质破坏病变，且无骨髓瘤或其他恶性肿瘤的证据，即使其他部位没有结核病证据，抗结核化疗试验也会是一种治疗方法。然而，不对骨病变进行活检及开展适当的微生物学检查可能会导致遗漏其他重要诊断。我们在下面报告的病例就说明了这一点。
