RESUMO
Se trata de un varón de 62 años, con antecedentes de tuberculosis pulmonar, que consulta en varias ocasiones a su médico de atención primaria por dorsalgia resistente al tratamiento analgésico/antiinflamatorio, y que generalmente coincide con la actividad física. Inicialmente se diagnosticó de dolor de características mecánicas pero ante la falta de respuesta al reposo y tratamiento, se solicitó resonancia magnética de columna que informó de metástasis óseas. Posteriormente se deriva al paciente para estudio hospitalario al servicio de medicina interna. La anatomía patológica descartó la presencia de células neoplásicas, y en las pruebas de imagen se evidenciaron alteraciones radiológicas en cuerpos vertebrales (osteomielitis-discitis), asociadas a absceso epidural, compatibles con mal de Pott tuberculoso (AU)
The case is presented of a 62 year old man with a history of pulmonary tuberculosis, repeatedly consulting his primary care physician for treatment of analgesic / anti-inflammatory resistant back pain, and usually coincided with physical activity. It was initially diagnosed as mechanical pain, but in the absence of response to rest and treatment a magnetic resonance of the spine was requested, which reported bone metastases. The patient was then referred to Internal Medicine for further tests in hospital. The histopathology ruled out the presence of neoplastic cells, and imaging tests showed radiographic abnormalities in vertebral bodies (osteomyelitis-discitis) associated with epidural abscess, compatible with Potts disease, a kind of tuberculous arthritis of the intervertebral joints (AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/terapia , Imageamento por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética/métodos , Tuberculose Pulmonar/fisiopatologia , Tuberculose Pulmonar , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/normas , Atenção Primária à Saúde , Anti-Inflamatórios/uso terapêutico , Osteomielite/complicações , Osteomielite , Tuberculose da Coluna Vertebral/complicaçõesRESUMO
The case is presented of a 62 year old man with a history of pulmonary tuberculosis, repeatedly consulting his primary care physician for treatment of analgesic / anti-inflammatory resistant back pain, and usually coincided with physical activity. It was initially diagnosed as mechanical pain, but in the absence of response to rest and treatment a magnetic resonance of the spine was requested, which reported bone metastases. The patient was then referred to Internal Medicine for further tests in hospital. The histopathology ruled out the presence of neoplastic cells, and imaging tests showed radiographic abnormalities in vertebral bodies (osteomyelitis-discitis) associated with epidural abscess, compatible with Pott's disease, a kind of tuberculous arthritis of the intervertebral joints.
