X-Ray Methods in the Diagnosis of Tuberculous Spondylitis and Osteomyelitis of the Spine

Spondylitis is an inflammatory disease of the spine, which is manifested destruction of the vertebral body and subsequent deformation of the spine. Under specific spondylitis more often (40-50%) is Tuberculosis of the spine. With the progression of tuberculosis process and the transition to the adjacent vertebrae and complicated clinical picture can resemble hematogenous osteomyelitis of the spine. Identification and differential diagnosis of tuberculosis of the spine is often associated with a number of difficulties arising largely nonspecific clinical picture of the disease and the hidden currents. Improving the diagnosis of tuberculous spondylitis, taking into account medical history, clinical manifestations, laboratory data and the results of surveys of patients radiological methods of research remains an urgent problem. The aim: to clarify the possibilities of radiological methods of examination and improving the efficiency of the differential diagnosis of tuberculous spondylitis and osteomyelitis of the spine. Material and methods. The results of a comprehensive clinical and instrumental examination of 46 patients with a diagnosis of “tuberculosis of the spine” and 71 patients with a diagnosis of “hematogenous osteomyelitis of the spine”, treated at Hospital of Phthisiopneumology for the period from 2010 to 2015. Results. X-ray examination of patients with suspected tuberculous lesion development spine is necessary to assess complaints, history and duration of the disease. For tuberculosis of the spine characterized by sluggish development of symptoms (p < 0.03) and the presence of TB burdened by history (p < 0.01), in contrast to osteomyelitis of the spine. For the purpose of differential diagnosis of tuberculosis and osteomyelitis of the spine was analyzed diagnostic value of methods of radiation diagnosis, which showed that high levels of sensitivity in the detection of tuberculosis of the spine occur in the application of computed tomography (89.7%) and multislice linear X-ray imaging (84.6%) compared with standard radiography (82.2%). The specificity of the method was respectively 84.0%, 79.3% and 76.1%. Conclusions. In our study clarified clinical-ray signs of tuberculous spondylitis and osteomyelitis of the spine and for the first time in world literature revealed signs of radiation at multislice linear X-ray tomography. Obtain performance indicators (sensitivity, specificity, accuracy) of different X-ray methods in the diagnosis of tuberculosis and osteomyelitis of the spine.

спондилит, туберкулез позвоночника, лучевая диагностика, томосинтез, spondylitis, tuberculosis of the spine, radiology, digital tomothyntesis

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