{"presentation":{"slides":[{"elements":[{"x":5.443790849673203,"y":8.656177105831533,"width":31.59041394335512,"height":8.639308855291576,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

A. Clinical Presentations<\/span><\/span><\/strong><\/span><\/p>\n"},"subContentId":"00fc9fe7-d9d1-451f-8b34-85ea00b63c04","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":5.443790849673203,"y":15.146911447084232,"width":90.41394335511983,"height":79.91360691144709,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

\n\t
Symptoms: <\/strong><\/span><\/li>\n<\/ul>\n\n
a) Persistent localized back pain or neck pain - earliest, MC symptom
\n b) Constitutional symptoms like fever, weight loss (maybe seen), loss of appetite
\n c) Deformity
\n d) Neurological deficit- motor (paraplegia\/paraparesis\/quadriplegia\/quadriparesis) \/sensory\/
\n bowel and bladder, respiratory paralysis<\/p>\n\n
\n\t
Presentation depends on the following: <\/strong><\/span>
\n\t
\n\ta) Stage of disease
\n\tb) Site- Lower thoracic & Upper lumbar are MC involved sites
\n\tc) Complications
\n\t <\/li>\n\t
Average duration of symptoms at the time of diagnosis is 3-4 months<\/strong><\/span><\/li>\n<\/ul>\n"},"subContentId":"a134ed23-4efa-4c7d-83ca-0a6025f3ca54","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":5.446623093681917,"y":8.639308855291576,"width":23.965141612200437,"height":8.639308855291576,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
B. When to Suspect <\/span><\/span><\/strong><\/span><\/p>\n"},"subContentId":"b8e18ab4-63e5-4edf-86ae-1a432c62beb5","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":5.44520697167756,"y":15.189092872570194,"width":89.32461873638344,"height":79.91360691144709,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
\n\t
\n\t
Localized back pain or neck pain for more than 6 weeks <\/strong><\/span><\/p>\n\t<\/li>\n\t
\n\t
Spinal tenderness*<\/p>\n\t<\/li>\n\t
\n\t
Spinal cord compression with paraplegia, paresis, impaired sensation, nerve root pain, or cauda equina syndrome. <\/p>\n\t<\/li>\n\t
\n\t
Spinal deformity, paraspinal muscle wasting. Kyphosis of some degree occurs in almost every patient. <\/strong><\/span><\/p>\n\t<\/li>\n\t
\n\t
Consitutional symptoms (Fever and weight loss)<\/p>\n\t<\/li>\n\t
\n\t
In children, failure to thrive, night cries, inability to walk\/ cautious gait, and use of hands to support the head or trunk are important signs.
\n\t
\n\t* Although usually present, epidural abscess may not have tenderness<\/em><\/p>\n\t<\/li>\n<\/ol>\n"},"subContentId":"0aeb3340-2910-4e34-9c38-7dde0aaac244","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":79.520697167756,"y":92.87257019438445,"width":15.250544662309368,"height":5.183585313174946,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
INDEX-TB guidelines 2016<\/span><\/span><\/span><\/span><\/span><\/p>\n"},"subContentId":"5680b61a-a2e8-4240-8841-f8d73ff50878","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":5.443790849673203,"y":8.656177105831533,"width":35.947712418300654,"height":8.639308855291576,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
C. Site of the Spinal Tuberculosis <\/span><\/span><\/strong><\/span><\/p>\n"},"subContentId":"53d0cc78-f804-4958-b1bd-3e05883eec70","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":5.446623093681917,"y":15.11879049676026,"width":89.32461873638344,"height":79.91360691144709,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
\n\t
Cervical spine<\/strong><\/span><\/li>\n<\/ul>\n\n
a) Retropharyngeal abscess, swelling in anterior or posterior triangle of neck or axilla
\n b) May present with torticollis alone<\/p>\n\n
\n\t
Thoracic <\/strong><\/span><\/li>\n<\/ul>\n\n
a) Fusiform paravertebral swelling, can present as a swelling in the chest
\n b) Scoliosis due to paraspinal muscle spasm<\/p>\n\n
\n\t
Lumbar <\/strong><\/span><\/li>\n<\/ul>\n\n
a) Psoas abscess with flexion deformity of the hip.
\n b) Track along femoral\/gluteal vessels to present as abscess in the femoral triangle\/gluteal region\/
\n anywhere in lower limb<\/p>\n"},"subContentId":"08d3dfe0-62b2-451a-a766-6535f4eb041f","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":5.443790849673203,"y":8.656177105831533,"width":35.947712418300654,"height":8.639308855291576,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
01. Tuberculosis at Cervical Spine <\/span><\/span><\/strong><\/span><\/p>\n"},"subContentId":"6e6930bb-0c4c-439d-913c-75819ff4050d","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":5.443790849673203,"y":15.146911447084232,"width":89.32461873638344,"height":60.47516198704104,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
\n\t
Less common, but potentially more serious <\/li>\n\t
Severe neurologic complications, retropharyngeal abscess formation with dysphagia\/dyspnea<\/li>\n\t
Lower cervical spine disease - dysphagia or stridor. <\/strong><\/span><\/li>\n\t
Upper cervical spine disease - respiratory failure (phrenic nerve\/ upper spinal cord)<\/strong><\/span><\/li>\n\t
Craniovertebral junction TB<\/li>\n<\/ul>\n\n
a) Secondary to retropharyngeal space infection
\n b) Erosion of the odontoid or C1 vertebra resulting in unstable articulation between the occiput and
\n C1, and atlanto-axial dislocation(C1-C2).<\/p>\n"},"subContentId":"4b38d341-202a-43c9-8ff2-4b869211c81f","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":47.930283224400874,"y":86.39308855291577,"width":47.930283224400874,"height":12.958963282937365,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Teegala R, Kumar P, Kale SS, Sharma BS. Craniovertebral junction tuberculosis: a new comprehensive therapeutic strategy. Neurosurgery. 2008 <\/span><\/p>\n"},"subContentId":"4c813aaf-f64f-43be-8c5e-8459bd276ac9","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":5.446623093681917,"y":8.639308855291576,"width":58.82352941176471,"height":8.639308855291576,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
D. Types: Paradiscal\/ central\/ Anterior\/ Appendicial<\/span><\/span><\/strong><\/span><\/p>\n"},"subContentId":"d3557b84-7de0-4826-bc44-83fa941507e6","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":5.446623093681917,"y":15.11879049676026,"width":55.55555555555556,"height":60.47516198704104,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
\n\t
1= Paradiscal: Most common, arterial spread (disc and adjacent para-discal body is supplied by same artery)<\/li>\n\t
2= Central: Venous<\/li>\n\t
3= Anterior: Subperiosteal spread<\/li>\n\t
4= Posterior: least common<\/li>\n<\/ul>\n\n
Note: arterial spread= contiguous vertebrae; venous spread can result in non contiguous central body lesions<\/p>\n"},"subContentId":"abcf404f-0295-4fac-b3bd-628e88f9e2a2","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":64.27015250544663,"y":17.278617710583152,"width":28.32244008714597,"height":74.08207343412528,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","file":{"path":"images\/file-649f0f475495c.jpg","mime":"image\/jpeg","copyright":{"license":"U"},"width":630,"height":838}},"subContentId":"084e61f8-4735-4904-9c0b-cd5845f558ee","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}}],"keywordListEnabled":true,"globalBackgroundSelector":{},"keywordListAlwaysShow":false,"keywordListAutoHide":false,"keywordListOpacity":90},"override":{"activeSurface":false,"hideSummarySlide":false,"summarySlideSolutionButton":true,"summarySlideRetryButton":true,"enablePrintButton":false,"social":{"showFacebookShare":false,"facebookShare":{"url":"@currentpageurl","quote":"I scored @score out of @maxScore on a task at @currentpageurl."},"showTwitterShare":false,"twitterShare":{"statement":"I scored @score out of @maxScore on a task at @currentpageurl.","url":"@currentpageurl","hashtags":"h5p, course"},"showGoogleShare":false,"googleShareUrl":"@currentpageurl"}},"l10n":{"slide":"Slide","score":"Score","yourScore":"Your Score","maxScore":"Max Score","total":"Total","totalScore":"Total Score","showSolutions":"Show solutions","retry":"Retry","exportAnswers":"Export text","hideKeywords":"Hide sidebar navigation menu","showKeywords":"Show sidebar navigation menu","fullscreen":"Fullscreen","exitFullscreen":"Exit fullscreen","prevSlide":"Previous slide","nextSlide":"Next slide","currentSlide":"Current slide","lastSlide":"Last slide","solutionModeTitle":"Exit solution mode","solutionModeText":"Solution Mode","summaryMultipleTaskText":"Multiple tasks","scoreMessage":"You achieved:","shareFacebook":"Share on Facebook","shareTwitter":"Share on Twitter","shareGoogle":"Share on Google+","summary":"Summary","solutionsButtonTitle":"Show comments","printTitle":"Print","printIngress":"How would you like to print this presentation?","printAllSlides":"Print all slides","printCurrentSlide":"Print current slide","noTitle":"No title","accessibilitySlideNavigationExplanation":"Use left and right arrow to change slide in that direction whenever canvas is selected.","accessibilityCanvasLabel":"Presentation canvas. Use left and right arrow to move between slides.","accessibilityProgressBarLabel":"Choose slide to display","containsNotCompleted":"@slideName contains not completed interaction","containsCompleted":"@slideName contains completed interaction","slideCount":"Slide @index of @total","containsOnlyCorrect":"@slideName only has correct answers","containsIncorrectAnswers":"@slideName has incorrect answers","shareResult":"Share Result","accessibilityTotalScore":"You got @score of @maxScore points in total","accessibilityEnteredFullscreen":"Entered fullscreen","accessibilityExitedFullscreen":"Exited fullscreen","confirmDialogHeader":"Submit your answers","confirmDialogText":"This will submit your results, do you want to continue?","confirmDialogConfirmText":"Submit and see results","slideshowNavigationLabel":"Slideshow navigation"}}

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Spinal Tuberculosis

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Spinal Tuberculosis

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