title: Early diagnosis of spinal tuberculosis.
abstract: Spinal tuberculosis (STB) is a common manifestation of extrapulmonary tuberculosis (TB). STB accounts for around 2% of all cases of TB and around 15% of extrapulmonary TB cases. The World Health Organization has proposed a global strategy and targets for TB prevention, care, and control after 2015. Under this strategy, patients will receive standard care according to the recommendations and guidelines after confirmation of STB diagnosis. However, current recommendations and guidelines focus on disease and medication therapy management, and recommendations for early detection or decision-making algorithms regarding STB are lacking. In this review, we identified five key components for early diagnosis: (1) risk factors for STB; (2) common symptoms/signs of STB; (3) significant neuroradiological findings of STB; (4) significant laboratory findings of STB, including positive interferon-γ release assays and nonpyogenic evidence in initial laboratory data; and (5) significant clinical findings of STB. Individualized consideration for each patient with STB is essential, and we hope that the algorithm established in this review will provide a valuable tool for physicians who encounter cases of STB.
authors: Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua City, Taiwan, ROC; Center for Infectious Diseases Research, Changhua Christian Hospital, Changhua City, Taiwan, ROC; Department of Nursing, College of Medicine and Nursing, Hung Kuang University, Taichung County, Taiwan, ROC. Electronic address: chenchanghuachad@gmail.com.
authors: Chang-Hua
authors: CH
authors: Chen
authors: Department of Pharmacy, Changhua Christian Hospital, Changhua City, Taiwan, ROC.
authors: Yu-Min
authors: YM
authors: Chen
authors: Department of Medical Imaging, Changhua Christian Hospital, Changhua City, Taiwan, ROC.
authors: Chih-Wei
authors: CW
authors: Lee
authors: Epidemiology and Biostatics Center, Changhua Christian Hospital, Changhua City, Taiwan, ROC.
authors: Yu-Jun
authors: YJ
authors: Chang
authors: Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua City, Taiwan, ROC.
authors: Chun-Yuan
authors: CY
authors: Cheng
authors: Department of Orthopedic Surgery, Changhua Christian Hospital, Changhua City, Taiwan, ROC.
authors: Jui-Kuo
authors: JK
authors: Hung
mesh_terms: D000465:Algorithms; D003657:Decision Making; D042241:Early Diagnosis; D006801:Humans; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D014399:Tuberculosis, Spinal / Q000175:diagnosis* / Q000628:therapy*; D014944:World Health Organization
keywords: algorithm; decision-making; early diagnosis; review; risk assessment; spine; tuberculosis