ANGULAR KYPHOSIS AS AN INDICATOR OF THE PREVALENCE OF POTTS DISEASE IN TRANSKEI

To understand better the prevalence, distribution and major causes of sagittal spinal deformity in a rural homeland, the authors conducted a study of angular kyphosis in the spines of 2 329 Transkei patients. T hirty-one (1,33%) had angular kyphosis. Lateral chest radiographs were obtained from 22 of these patients. Radiographic kyphotic angles rang ed from 28 degrees to 130 degrees (mean: 70,3 +/- 7,6). The vast major ity (81%) demonstrated classical clinical and/or radiographic findings of tuberculous aetiology. Less frequent aetiologies included fracture s (2), osteoporosis (1), congenital malformation (1) and kyphosis of u nknown origin (2). Eleven of the kyphotic patients were seeking care f or unrelated problems and were asymptomatic in respect of their kyphos es. As a subset, the asymptomatic individuals demonstrated a similar a etiological distribution, with 73% strongly suggestive of tuberculous aetiology. The prevalence of asymptomatic angular kyphosis in this uns elected Transkei patient population was 0,47% +/- 0,14%. In this hospi tal-based study, angular kyphosis proved a valuable marker for spinal tuberculosis. Because tuberculous spondylitis is more successfully tre ated when detected early, spinal palpation should be included in the r outine physical examination of patients or populations at risk for tub erculosis.