TUBERCULOUS SPONDYLITIS AS A CAUSE OF INFLAMMATORY SPINAL PAIN - A REPORT OF 4 CASES

Patients are said to have inflammatory spinal pain if they fulfill at presentation 4 of the following 5 criteria: duration of spinal discomf ort for at least 3 months, spinal morning stiffness, age less than 40, insidious onset of symptoms, and no relief from pain with rest but im provement with exercise. Inflammatory spinal pain is typical of the sp ondylarthropathies. Only in a minority of the cases it is found in oth er rheumatic disorders such as rheumatoid arthritis, fibromyalgia or i nfectious spondyilitis. Tuberculous spondylitis is rarely mentioned as a possible cause of inflammatory spinal pain. We describe 4 patients with tuberculous spondylitis seen over a 3-year period who met the cli nical criteria for inflammatory spinal pain at presentation. We conclu de that inflammatory spinal pain may be a presenting feature, albeit r are, of tuberculous spondylitis. Awareness of this finding should help facilitate the proper diagnosis and the institution of appropriate th erapy.