Eighteen cases of bone and joint tuberculosis in children were diagnosed in the Stockholm region (about 1,500,000 population) over the period 1961-1974. BCG infection was verified by culture and identification of bacterial type in seven, all after 1968. The same origin can be presumed in most of the remaining eleven cases, in spite of the absence of bacterial verification. The increased frequency of complications after BCG vaccination may necessitate a revision of the vaccination programme. We recommend operative treatment, which has not led to any growth disturbances or impairment of joint function, although the lesions were invariably localised close to growth zones and joints.
A birth injury in the vicinity of a joint might lead to a fracture through the epiphyseal cartilage. The criteria for diagnosing such a fracture at radiography are considered and the continued remodelling of the bone demonstrated. The history of 2 cases with late diagnosis and serious long-term sequelae are described, in order to emphasize the necessity of early radiography.
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