Abstract
There are few patients with bone and joint tuberculosis now in Japan. Therefore, patients who appear to be cases of doctor's delay are increasing.
Recently, we could diagnose a patient as lumbar spinal tuberculosis at a relatively early stage by computed tomography (CT). We also had experiences of treating two other patients with lung tuberculosis, before they were correctly diagnosed as spinal tuberculosis.
The former was a 44 year old man. During his admission due to tuberculous pleuritis, his low back pain increased. We could recognize the abscess at the intervertebral disc level between L4 and L5 by CT under the condition of imaging soft tissue.
One patient of the latter, a 72 year old man was operated on the diagnosis of spinal osteomyelitis between T7 and T8. After then, he suffered from tuberculous pleuritis and he was subsequently diagnosed as spinal tuberculosis.
Another patient of the latter, a 53 year old woman had high fever while under treatment for lumbar disc herniation. She was diagnosed as miliary tuberculosis and then was correctly diagnosed as spinal tuberculosis.
We can protect against cases of doctor's delay for bone and joint tuberculosis diagnosis, if we take enough care about the patient's history, X-ray and CT results. We should not forget that patients can become seriously ill if a misdiagnosis is made.
CT under the condition of imaging soft tissue is one method that we should try to ensure correct diagnosis.
