Orthopaedics

Points commonly asked in exam:
1. Spine is the commonest site of bone and joint tuberculosis.
2. Paradiscal is the commonest type of spinal tuberculosis.
3. Anti-tubercular chemotherapy forms the mainstay of treatment.
4. The spine is put to absolute rest by sling traction for the cervical spine and bed rest for dorsolumbar spine.
5. Pott’s paraplegia is TB spine with neurological involvement. It occurs most commonly in tuberculosis of the dorsal spine because the spinal canal is narrowest in this part.
6. The onset of paraplegia is gradual in onset in most cases but in some it is sudden.
7. Tubercular paraplegia is usually spastic to start with clonus (ankle or patellar) is the most prominent early sign.
8. Reduction of disc space is the earliest sign in the commoner, paradiscal type of tuberculosis.
9. Reduction of disc space is an important sign because in other diseases of the spine e.g., secondaries in spine, disc space is well preserved.
10. Back pain is commonest presenting symptom in Pott’s disease.
11. Stiffness is very early symptom in TB spine.
12. TB of spine is always secondary.
13. Commonest cause of early onset paraplegia is abscess