Tag Archive for: biopsy

Volume 4 | Issue 1 | April 2023 – September 2023 | page: 28-31 | Meet Shah, Ashok Rathod, Punith K, Rohan Killekar, Kunal Bharadwaj

DOI: https://doi.org/10.13107/bbj.20232.v04i01.057

Authors: Meet Shah, Ashok Rathod, Punith K, Rohan Killekar, Kunal Bharadwaj

[1] Department of Orthopaedics, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India.

Address of Correspondence

Dr. Meet Shah,
Department of Orthopaedics, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India.
E-mail: meetkshah29@gmail.com

Abstract

Introduction: Tuberculosis is one of the leading causes of mortality worldwide due to a single infectious agent. Koch’s spine or spinal tuberculosis is one of the most crippling manifestations of extra-pulmonary tuberculosis. Owing to the lack of image-guided biopsy centers and the high prevalence of the disease, most of the patients are diagnosed and treated on clinical grounds. This practice was thought to lead to a delay in the diagnosis of other pathologies and multi-drug-resistant tuberculosis. This study aims to compare the diagnostic yield of fluoroscopy (C-arm) guided transpedicular biopsy done by orthopaedicians v/s CT guided biopsy done by radiologists in cases of Koch’s spine.
Materials and Methods: The study involved 60 consented patients with a clinico-radiological diagnosis of Koch’s spine randomly divided into 2 groups for biopsy 1) CT-guided biopsy to be done by radiologists 2) C-arm guided biopsy to be done by orthopedicians and results were compared.
Results: The use of CT-guided biopsy and C-arm guided biopsy in the diagnosis of Koch’s spine is increasing taking into consideration of increasing MDR TB. We got a positive answer in 70% of cases via CT-guided biopsy and 53.33% via C-arm guided biopsy. Detection of MDR TB on GeneXpert was the commonest diagnostic feature with a comparatively low rate of positive AFB smear and histopathology.
Conclusion: Results of C-arm guided biopsy are similar to CT guided biopsy with the latter being better.
Keywords: Koch’s spine, biopsy, multi-drug resistant tuberculosis

References

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