The Daily PANCE and PANRE Question 8

A 48-year-old nurse, with a body mass index of 31, presents for an evaluation of back pain. She relates that historically, she had a positive PPD test a year ago and did not follow-up as directed. She has recently been experiencing night sweats and coughing. An x-ray of her lumbar spine reveals osteopenia and cortical breakdown of vertebral bodies L4 and L5. Which of the following diagnosis is most suspect?

  1. compression fractures secondary to obesity
  2. degenerative joint disease
  3. Pott's disease
  4. compression fractures secondary to osteoporosis
  5. spondylolisthesis

Answer: C

Pott's disease

Pott's disease is TB of the spine. She could have any of the other diseases, but the question states that she had a positive PPD and did not take meds...that is the clue that she has active TB in the spine.

Bonus: What is the definition of osteopenia?
T score less than – 2.5 = OSTEOPOROSIS T score (-1 to – 2.4) OSTEOPENIA

Know Your Content Blueprint

Tuberculosis is part of the NCCPA Content Blueprint Pulmonary System (12%)

Read more and watch a ReelDx™ patient case video presentation at Smarty PANCE Tuberculosis

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