Low back pain: Think of tuberculosis

doi:10.1136/bmj.333.7560.201

BMJ 2006;333:201 (22 July), doi:10.1136/bmj.333.7560.201

Letter

Low back pain

Think of tuberculosis

The first 150 words of the full text of this article appear below.

EDITOR—Koes et al in their clinical review on low backpain identify some red flags that may indicate underlying spinaldisease in people presenting with back pain.¹

We recently completed a retrospective study of patients withspinal tuberculosis at Ealing Hospital. Of 29 adult patientsdiagnosed between 2002 and 2005, 23 (80%) were aged between20 and 50 years (mean age 38.5 years). All were originally fromthe Indian subcontinent or Africa. Most patients had been inthe United Kingdom for more than 5 (range 1-26) years. Nonewas HIV positive, gave a history of carcinoma, or reported steroiduse. Only four (14%) had a history of previous tuberculosisor close contact with someone with tuberculosis. Almost allof the patients gave a history of constitutional symptoms (fever,night sweats, weight loss, or loss of appetite). Lumbar andcervical back pain was seen more commonly than thoracic. The. . . [Full text of this article]

Lavanya Diwakar, clinical research fellow

klavanya99@yahoo.com, Department of Infectious Diseases, Level 8, Pasteur Suite, Ealing Hospital, Middlesex UB1 3HW

Sarah Logan, specialist registrar, Nadia Ghaffar, F1 trainee, Andrew Hare, TB specialist nurse, William Lynn, consultant, Steve Ash, consultant

Department of Infectious Diseases, Level 8, Pasteur Suite, Ealing Hospital, Middlesex UB1 3HW