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ORIGINAL ARTICLE
Year : 2017  |  Volume : 3  |  Issue : 2  |  Page : 81-84

Neck pain in a young girl: A pott's disease case study


1 Assistant Professor, Department of Physical Medicine and Rehabilitation Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
2 Professor, Department of Physical Medicine and Rehabilitation Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
3 Resident, Department of Physical Medicine and Rehabilitation Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
4 Medical Officer, Department of Physical Medicine and Rehabilitation, National Institute of Traumatology & Orthopaedic Rehabilitation, Dhaka, Bangladesh

Correspondence Address:
Nuruzzaman Khandaker
Assistant Professor, Department of Physical Medicine and Rehabilitation Bangabandhu Sheikh Mujib Medical University, Dhaka
Bangladesh
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Source of Support: None, Conflict of Interest: None


DOI: 10.5005/jp-journals-10046-0074

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Cervical spinal tuberculosis (TB) is a rare variant of extrapulmonary TB with a high complication rate. Tuberculosis of the cervical spine is reported in about 6 to 9% of all cases of spinal TB. Early diagnosis and treatment of spinal TB is essential in order to prevent neural deficit. Management strategies for spinal TB range from ambulatory chemotherapy to radical surgical debridement with fusion. We present a case of an Old Dhaka citizen, 15-year-old girl, who was admitted to the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University, because of a severe painful restriction of neck movement with torticollis to left for 5 months, neck stiffness, and restriction of neck movement in all planes of cervical spine. On physical examination, the girl was subfebrile, mildly anemic, and tenderness present over the upper part of cervical spine. Head was deviated toward left side. Neurological examination revealed no focal motor weakness. The roentgenograms of chest, pelvis, and cranium were without pathological changes. Abdominal ultrasonography was normal. A magnetic resonance imaging scan revealed marrow contusion in body of C2 with odontoid process, adjacent anterior and left side of prevertebral soft tissue swelling with small collection at C2 level, and scoliosis with straightening of cervical spine. Histopathological examination of the removed material showed typical granulomatous inflammation with characteristic infiltrate of lymphocytes, epithelioid macrophages, and Langhans-type multinucleated giant cells.


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