Vertebral tuberculosis: a growing concern in London

Vertebral tuberculosis: a growing concern in London
The incidence of vertebral tuberculosis (TB) in the UK, particularly East London, is increasing. The lower thoracic and upper lumbar vertebrae are the areas most often affected. Vertebral TB usually results from haematogenous spread of TB from other sites, often pulmonary. Then as the infection spreads, it involves the intervertebral disc which then collapses, and replaced by caseation. Presenting the paper, ’Vertrbral tuberculosis in East London: Whistle blowing’, at the Society for Back Pain Research (SBPR) 2007 in Helsinki, Finland, Mr Fras Dakhil-Jerew, reported that in 2005 the London region accounted for a substantial proportion of TB cases (43%) in the UK, and also had the highest rate of disease (46.3 per 100,000). TB has been prevalent in the UK since 1900, and Britons have long blamed the Roman Empire for bringing the disease into the isle as long as the first century AD, explained Dakhil- Jerew. Interestingly, more recently an archaeologist and molecular biologist discovered traces of TB on 2,300-year-old human remains that were unearthed in the 1970s and lay undated until 2001 in a museum in Tarrant Hinton, near England’s southwest coast. Diagnosis of the disease is usually conducted by magnetic resonance imaging (MRI) as well as a knowledge of the patient’s history. However, Dakhil-Jerew explained that diagnostic evaluation of TB is hampered by the difficulty of MRI interpretation and "failing to keep a high index of suspicion." Presently, it seems that the problem is associated with the rise in occurrence of the disease particularly in East London and is due to lack of awareness from physicians and misdiagnosis.