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What Causes Pain On Both Sides Of Spinal Cord?
Question: Dear Sir,
Am 26yrs old weighing 63kgs.
Below is my health history.
* Before 5 months it just started as a hip pain on one side and later pain spread to other side. The pain got worse as the days passed. So I went to doctor. Blood test and x-ray were taken. Then the doctor advised to do physiotherapy exercise for two weeks. No improvement in the pain.
* Then the body started becoming weak. I experienced fatigue, cough and sometimes fever during night. The cough become worse so I went to pulmonary doctor. It was found from sputum test that there was moderate bacterial infection(not MTB). Took medicines for that.
* Right leg started giving more pain as I walk. I could not walk for long distance. Felt like nerve stiffness. Again I went to Ortho doctor. Advised x-ray and MRI. MRI suggestive of spine TB at L5 - S1.
To confirm it, blood test - EDT, PCR, mantoux test performed. MTB not detected from these tests.
* Doctor suggested CT guided biopsy. Biopsy was done and Tissue sample was taken from L5 - S1. GeneXpert test reported that MTB not detected. Culture report of the tissue said no organism found no growth.
After seeing the biopsy report doctor said it to be spine TB. Now am in ATT for around one and half months.
Meanwhile I got pain on both sides of spinal cord.
Now my condition as below:
* leg pain has reduced somewhat.
* There is small improvement with the pain on the sides of the spine. But still there is pain on the sides of spine while sleeping.
* There is no improvement with the pain on either side of the hip. The pain just gets worse.
* Often I feel stiffness/ weakness in the hands and in the body.
Am not able to bend down.
Am really worried about all these things. Spent lot of money for the diagnosis itself.
My question is that whether my diagnosis is correct? Does the report suggests any other condition other than TB? If the diagnosis is correct then why does I don't feel improvement in the pain? Past one and half month am taking medicines and good diet. When will I feel good.
I have not got any injury. Can it be cancer?
Please please advice. I have attached all the reports.
Am 26yrs old weighing 63kgs.
Below is my health history.
* Before 5 months it just started as a hip pain on one side and later pain spread to other side. The pain got worse as the days passed. So I went to doctor. Blood test and x-ray were taken. Then the doctor advised to do physiotherapy exercise for two weeks. No improvement in the pain.
* Then the body started becoming weak. I experienced fatigue, cough and sometimes fever during night. The cough become worse so I went to pulmonary doctor. It was found from sputum test that there was moderate bacterial infection(not MTB). Took medicines for that.
* Right leg started giving more pain as I walk. I could not walk for long distance. Felt like nerve stiffness. Again I went to Ortho doctor. Advised x-ray and MRI. MRI suggestive of spine TB at L5 - S1.
To confirm it, blood test - EDT, PCR, mantoux test performed. MTB not detected from these tests.
* Doctor suggested CT guided biopsy. Biopsy was done and Tissue sample was taken from L5 - S1. GeneXpert test reported that MTB not detected. Culture report of the tissue said no organism found no growth.
After seeing the biopsy report doctor said it to be spine TB. Now am in ATT for around one and half months.
Meanwhile I got pain on both sides of spinal cord.
Now my condition as below:
* leg pain has reduced somewhat.
* There is small improvement with the pain on the sides of the spine. But still there is pain on the sides of spine while sleeping.
* There is no improvement with the pain on either side of the hip. The pain just gets worse.
* Often I feel stiffness/ weakness in the hands and in the body.
Am not able to bend down.
Am really worried about all these things. Spent lot of money for the diagnosis itself.
My question is that whether my diagnosis is correct? Does the report suggests any other condition other than TB? If the diagnosis is correct then why does I don't feel improvement in the pain? Past one and half month am taking medicines and good diet. When will I feel good.
I have not got any injury. Can it be cancer?
Please please advice. I have attached all the reports.
Brief Answer:
Your diagnosis is correct.
Detailed Answer:
Hi
Thanks for your query
I'm Dr Sudhir Kumar
I have gone through your query and various reports and understand your concern. Your diagnosis is correct. Your diagnosis suggest you have tuberculosis of spine( spine TB). Your report doesn't suggest any other conditions.There has started some improvements as pain has reduced on sides of spine. The pain in tuberculosis reduce gradually, starting improvement from one to one and half months after starting treatment. You are likely to be feel much better from nearby 1 month from now. It is unlikely to be cancer as biopsy has excluded it. My advise is that you continue with rest and antitubercular treatment. I think you are on right path.
Hope your query is answered. If you have any clarification then I will be happy to help you.
Wishing you a good health.
Take care.
Your diagnosis is correct.
Detailed Answer:
Hi
Thanks for your query
I'm Dr Sudhir Kumar
I have gone through your query and various reports and understand your concern. Your diagnosis is correct. Your diagnosis suggest you have tuberculosis of spine( spine TB). Your report doesn't suggest any other conditions.There has started some improvements as pain has reduced on sides of spine. The pain in tuberculosis reduce gradually, starting improvement from one to one and half months after starting treatment. You are likely to be feel much better from nearby 1 month from now. It is unlikely to be cancer as biopsy has excluded it. My advise is that you continue with rest and antitubercular treatment. I think you are on right path.
Hope your query is answered. If you have any clarification then I will be happy to help you.
Wishing you a good health.
Take care.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Dear Doctor,
Thankyou for the precise answer.
I have below questions:
* If it is TB, who does MTB not detected in blood test (PCR) and GeneXpert test?
* The same tissue sample is used for biopsy report and culture test. In culture test no organism found no growth. So why MTB not detected in culture test and how it was found in biopsy report?
* After two months of treatment I have been advised to take blood test. Since MTB not detected through blood test then what is the usefulness of the blood test after treatment?
* Hip is the place from where the pain started. Still that pain didn't reduce. That is why am worried whether the treatment is correct.
Since MTB not detected from these tests, can it be any organism other than mycobacterium. What is the possibility of MOTT infection? Can it be MDR - TB?
Thankyou for the precise answer.
I have below questions:
* If it is TB, who does MTB not detected in blood test (PCR) and GeneXpert test?
* The same tissue sample is used for biopsy report and culture test. In culture test no organism found no growth. So why MTB not detected in culture test and how it was found in biopsy report?
* After two months of treatment I have been advised to take blood test. Since MTB not detected through blood test then what is the usefulness of the blood test after treatment?
* Hip is the place from where the pain started. Still that pain didn't reduce. That is why am worried whether the treatment is correct.
Since MTB not detected from these tests, can it be any organism other than mycobacterium. What is the possibility of MOTT infection? Can it be MDR - TB?
Brief Answer:
Your MRI report ,biopsy report suggests diagnosis.
Detailed Answer:
Hi
Welcome back
Your MRI report and biopsy report suggests diagnosis of tuberculosis. Answer to your questions.
1.Many a time MTB is not detected in blood PCR and GeneXpert test.
2. As per the tissue biopsy which is a gold standard investigation for MTB, it was positive. The tissue structure is seen in tissue biopsy. There is no culture report here so they might not have done it. MRI shows TB type lesions which increases the suspicion towards TB.
3. Blood test are seen to see progress of treatment such as ESR etc. MTB are unlikely to be detectable directly in blood after treatment of 2 months. Disease progression is judged indirectly by other markers in blood such as ESR.
4.You are worried about hip pain. Pain reduces very gradually. However you can get hip MRI later to look out for other hip conditions.
There is very less possibility of any organism other than mycobacterium. MOTT is again a very little possiblity as it is rare. It is less likely to be MDR -TB as your pain started reducing but it can be only find out definitely by culture and sensitivity of Mycobacterium tuberculosis.
You can discuss with your doctor about it.
Everything else already discussed.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho
Wishing you good health
Take care
Your MRI report ,biopsy report suggests diagnosis.
Detailed Answer:
Hi
Welcome back
Your MRI report and biopsy report suggests diagnosis of tuberculosis. Answer to your questions.
1.Many a time MTB is not detected in blood PCR and GeneXpert test.
2. As per the tissue biopsy which is a gold standard investigation for MTB, it was positive. The tissue structure is seen in tissue biopsy. There is no culture report here so they might not have done it. MRI shows TB type lesions which increases the suspicion towards TB.
3. Blood test are seen to see progress of treatment such as ESR etc. MTB are unlikely to be detectable directly in blood after treatment of 2 months. Disease progression is judged indirectly by other markers in blood such as ESR.
4.You are worried about hip pain. Pain reduces very gradually. However you can get hip MRI later to look out for other hip conditions.
There is very less possibility of any organism other than mycobacterium. MOTT is again a very little possiblity as it is rare. It is less likely to be MDR -TB as your pain started reducing but it can be only find out definitely by culture and sensitivity of Mycobacterium tuberculosis.
You can discuss with your doctor about it.
Everything else already discussed.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho
Wishing you good health
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Thank you for the response. I got a clear view now.
I have one more thing to be clarified.
Does the report indicates any serious issue that needs a surgery? Does ATT medicines alone are enough to cure all the conditions mentioned in MRI, x-ray and biopsy report.
Are there tumours? Can you explain the reports(MRI, x-ray) in simple terms in a way I can understand.
Thank you for the response. I got a clear view now.
I have one more thing to be clarified.
Does the report indicates any serious issue that needs a surgery? Does ATT medicines alone are enough to cure all the conditions mentioned in MRI, x-ray and biopsy report.
Are there tumours? Can you explain the reports(MRI, x-ray) in simple terms in a way I can understand.
Brief Answer:
This does not require surgery at present.
Detailed Answer:
Hi
Welcome back
This can be treated by rest and ATT treatment. Operative treatment is indicated only if your condition deteriorate even after taking ATT treatment or there is any cold abcess pointing or there is any deterioration of condition. Otherwise ATT and rest is only required treatment. These are not tumours. MRI report says there are destruction of L5 and S1 vertebrae and abcess formation around this. Biopsy report shows changes which are seen in tuberculosis such as granuloma with langerhans giant cells. There are no malignant cells which indicates malignancy ( so there is no cancer).
Everything else already discussed.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho
Wishing you good health
Take care
This does not require surgery at present.
Detailed Answer:
Hi
Welcome back
This can be treated by rest and ATT treatment. Operative treatment is indicated only if your condition deteriorate even after taking ATT treatment or there is any cold abcess pointing or there is any deterioration of condition. Otherwise ATT and rest is only required treatment. These are not tumours. MRI report says there are destruction of L5 and S1 vertebrae and abcess formation around this. Biopsy report shows changes which are seen in tuberculosis such as granuloma with langerhans giant cells. There are no malignant cells which indicates malignancy ( so there is no cancer).
Everything else already discussed.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho
Wishing you good health
Take care
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dear Doctor,
After taking the ATT medicines, I feel headache and some changes to my eye(little irritation and blurring). Is is due to the medicines? What should I do for this?
Kindly advice.
After taking the ATT medicines, I feel headache and some changes to my eye(little irritation and blurring). Is is due to the medicines? What should I do for this?
Kindly advice.
Brief Answer:
These are likely to be due to medicines.
Detailed Answer:
Hi
Welcome back
Some headache can be there,you need not to worry much about it. Eye changes can also may be ATT drugs. You need to check your eye from ophthalmologist for any eye effect. You are also advised to contact your treating doctor about these symptoms.
Everything else already discussed.
If you have any further query, I would be glad to help you.
Wishing you good health
Take care
These are likely to be due to medicines.
Detailed Answer:
Hi
Welcome back
Some headache can be there,you need not to worry much about it. Eye changes can also may be ATT drugs. You need to check your eye from ophthalmologist for any eye effect. You are also advised to contact your treating doctor about these symptoms.
Everything else already discussed.
If you have any further query, I would be glad to help you.
Wishing you good health
Take care
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
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