~10-35 % of extra-pulmonary Tb is skeletal Tb, most common form is Pott’s disease (Spondylitis)
Differential for malignancy related bone involvement
-Metastatic disease much more common than primary bone cancer
Mnemonic for cancers that go to bone: BLT + Mayo and a Kosher Pickle
Don’t forget about infections!
–Infection (eg: staph aureus osteomyelitis), histoplasmosis, coccidomycosis, Tb!
Extra-pulmonary Tb-it’s not just in the lungs!
Miliary Tb=clinical disease from hematogenous spread of Mycobacterium Tb, can spread to…
–Lungs- (>50 % of patients with Miliary Tb)
-Lymphatic disease-Tb lymphadenitis
–Bone and joint disease- Pott’s disease, skeletal Tb
-GI disease-TB enteritis, peritonitis or hepatic disease
–CNS-Tb meningitis, tuberculoma
-Genitourinary, adrenal disease-renal papillary disease, adrenal insufficiency
–Skin-Tb Cutis Miliaris
Tb can spread everywhere, make the diagnosis by biopsy and AFB stain & culture, treatment is with RIPE therapy