TUBERCULOUS SPONDYLITIS: A CLINICAL CASE

Introduction: The tuberculous spondylitis (TBS) is responsible for 10% of the extra-pulmonary forms of tuberculosis. TBS is manifested by pain and stiffness of movements. The bone destruction causes vertebral collapse and formation of abscess can lead to spinal compression. The aspiration of abscess or bone biopsy confirms the aetiology. Objective: Demonstrate the role of the family physician (FP) in recognizing unusual diseases. Methodology: Interview, consultation of the clinical process and bibliographical research. Male, caucasian, 73 years old, married went to FP presenting neck pain with 5 days of evolution without irradiation. Results: On physical examination showed cervical rigidity without sensitivity deficits. The patient was medicated and an X-ray of the cervical spine demonstrated cervical spondylosis. Months later the patient returned with a mass in the left cervical region associated with imbalance and loss of sensation in the fingers. Ultrasound and CT SCAN of cervical spine was requested. These exams suggested that the tumor formation could be a chondrosarcoma. The patient was oriented to Hospital where MRI was performed and also suggested chondrosarcoma or osteochondroma. The patient had serology and tumor markers negatives. The aspiration of abscess was positive for Mycobacterium tuberculosis, TBS was diagnosed. Conclusions: The diagnosis of TBS is a challenge and can be confused with other diseases. The location of TBS on the cervical spine is infrequent, the lower thoracic and upper lumbar region are the most affected in adults. This case demonstrate the importance of the FP on guidance of unusual diseases.