Pott's disease

  Pott's disease is a presentation of extrapulmonary tuberculosis that affects the spine, a kind of tuberculous arthritis of the intervertebral joints. More precisely it is called tuberculous spondylitis and the original name was formed after Percivall Pott (1714-1788), a London surgeon. It is most commonly localized in the thoracic portion of the spine.

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Signs and symptoms

• back pain
• fever
• night sweating
• anorexia
• weight loss
• Spinal mass, sometimes associated with numbness, tingling, or muscle weakness of the legs

Diagnosis

• blood tests - elevated erythrocyte sedimentation rate
• tuberculin skin test
• radiographs of the spine
• bone scan
• CT of the spine
• bone biopsy
• MRI

Late complications

• Vertebral collapse resulting in kyphosis
• Spinal cord compression
• sinus formation
• paraplegia (so called Pott's paraplegia)

Therapy

• non-operative - antituberculous drugs
• analgesics
• immobilization of the spine region by rod
• Surgery may be necessary, especially to drain spinal abscesses or to stabilize the spine

Prevention

Controlling the spread of tuberculosis infection can prevent tuberculous spondylitis and arthritis. Patients who have a positive PPD test (but not active tuberculosis) may decrease their risk by properly taking medicines to prevent tuberculosis. To effectively treat tuberculosis, it is crucial that patients take their medications exactly as prescribed.

Cultural references

The fictional Hunchback of Notre Dame had a gibbous deformity (humpback) that is thought to have been caused by tuberculosis. Furthermore, Jocelin, the Dean who wanted a spire on his cathedral in William Golding's "The Spire" probably suffered and died as a result of this disease. The 18th-century English poet Alexander Pope suffered from Pott's disease.