Pott disease is tuberculosis of the spine, usually due to haematogenous spread from other sites, often the lungs. The lower thoracic and upper lumbar vertebrae areas of the spine are most often affected. It causes a kind of tuberculous arthritis of the intervertebral joints. The infection can spread from two adjacent vertebrae into the adjoining intervertebral disc space. If only one vertebra is affected, the disc is normal, but if two are involved, the disc, which is avascular, cannot receive nutrients, and collapses. In a process called caseous necrosis, the disc tissue dies, leading to vertebral narrowing and eventually to vertebral collapse and spinal damage. A dry soft-tissue mass often forms and superinfection is rare. Spread of infection from the lumbar vertebrae to the psoas muscle, causing abscesses, is not uncommon.The disease is named after Percivall Pott, the British surgeon who first described it in the late 18th century. Diagnosis
Blood tests– Complete blood count: leukocytosis
– Elevated erythrocyte sedimentation rate: >100 mm/hTuberculin skin test– Tuberculin skin test (purified protein derivative [PPD]) results are positive in 84–95% of patients with Pott disease who are not infected with HIV. Radiographs of the spine– Radiographic changes associated with Pott disease present relatively late. These radiographic changes are characteristic of spinal tuberculosis on plain radiography:
Lytic destruction of anterior portion of vertebral body
Increased anterior wedging
Collapse of vertebral body
Reactive sclerosis on a progressive lytic process
Enlarged psoas shadow with or without calcification
– Additional radiographic findings may include:
Vertebral end plates are osteoporotic. Intervertebral disks may be shrunken or destroyed.
In Henrik Ibsens play A Dolls House, Dr. Rank has "consumption of the spine". Jocelin, the dean who wanted a spire on his cathedral in William Goldings The Spire, probably died as a result of the disease. Morton, the railroad magnate in the film Once Upon a Time in the West, has the disease and needs crutches to walk. Imogen, in the novella "The Princess with the Golden Hair", part of Memoirs of Hecate County by Edmund Wilson (1946), has Pott disease. In the story Two Gentlemen of Verona, written by A. J. Cronin, Lucia had tuberculosis of spine. References
External links
Pott Disease — Tuberculous Spondylitis (medical article with MRI picture), eMedicine, 2018-08-30. "Tuberculous arthritis", MedlinePlus, USA: NIH. Public domain. Potts Disease of the Thoracic Spine