Nasreen Naz, Aslam Siddiqui, Mehtab Ahmed Pirwani, Ataur Rehman.
Role of plain radiography in diagnosis in diagnosis of Koch’s spine.
J Pak Orthop Assoc Jan ;20(1):20-5.

Objective: To assess the radiological features of Koch’s spine on plain X - ray. Study Design: A descriptive study. Place and Duration of Study: Department of Radiology and Orthopaedic Unit II, Civil Hospital and Dow University of Health Sciences, Karachi, Pakistan, from January 2006 to September 2007. Patients and Methods: In this study, 120 patients, diagnosed cases of tuberculosis of spine, were included as indoor (admitted) and outdoor patients. Clinical features of the patients were noted and detailed data of the patients were collected on pre-formed profroma. Diagnosed cases of tuberculous spine were included in this study. The patients having nontubercular spondylitis were excluded from the study. Result: A total 120 cases of tuberculous spine were seen during the study period. These consist of 66 males (55%) and 54 females (45%) with mean age of 33 years. The most commonly affected level of spine was lower thoracic and upper lumbar vertebrae (43%). Ten cases of T.B. cervical spine were also present (12%). The most common symptom was backache in 76 cases (63%). Local tenderness with spinal cord compression was found in 36 cases (30%). The most specific investigation was plain radiograph of the spine. In almost 95%, cases intervertebral disc space was involved (reduced). The radiological features of 120 cases of T.B. spine on plain X - ray were seen as: Wedge collapse of body 24 (20%); Destruction of disc 48 (40%); Complete destruction of the body 32(26%); Osteopenia of body 20(16%); Paraspinal abscess 44(36%); Calcification 36(30%). Conclusion: The incidence of tuberculosis of the spine is rising in our country. It effects males more than females, the involvement is mainly found in the lower thoracic and the upper lumbar spine which, if not treated effectively, causes severe deformities and disability. The most common pattern of TB spine is Pott’s disease. In all cases, plain X - ray spine was used as a primary and baseline imaging modality and we found satisfactory results as far as diagnostic support of TB spine was concerned.

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