A decade of skeletal tuberculosis.

Abstract

SUMMARY Thirty-eight of 58 patients with skeletal tuberculosis (TB) reviewed were immigrants and 20 were of British indigenous origin. Spinal involvement in 28 cases was less common than involvement of peripheral joints, bones, or tendon sheaths (30 cases). Predisposing factors, including previous TB, were present in 70% of British patients and 31 % of immigrants. Follow-up study of 23 cases showed that a complete clinical recovery of the skeletal disease was more likely in immigrants than indigenous cases and also in cases referred to hospital early. Immigrants presented usually within 5 years after arrival in Britain and at a younger age than indigenous cases; a quarter had additional sites of infection outside the skeletal system. Skeletal tuberculosis in the indigenous population remains very uncommon, and in half of these cases a history of previous TB was given. The need for continued awareness of skeletal TB is stressed, especially in immigrants, and also the importance of early diagnosis and institution of appropriate therapy.In the British Isles the incidence of tuberculosis (TB), both pulmonary and extrapulmonary, has been steadily declining, and in the past 20 years has fallen by 12 % per annum.1 However, the notification rate of TB in immigrants, particularly Asians, has been steadily increasing. In some centres in Britain TB is now more common in immigrants than in the indigenous population.2 3 Skeletal TB remains a rare site of extrapulmonary TB and now presents infrequently to most hospital departments. It is recognised that early diagnosis is important, as early treatment results in cure and avoids the high morbidity that occurred before antituberculous therapy came in. We have undertaken a retrospective and follow-up study to assess the experience gained by all departments of the London Hospital in

Tuberculous Arthritis: A Review of 27 Cases

“…This is similar to other studies, averaging 58% with a range of 50%-73%. [1][2][3][4][5][6][7][8][9]15,16 The disease was monoarticular in all of our patients. Others had slightly lower percentages of 80%-91%.…”

“…This is also similar to results of other reported studies. [1][2][3][4][5][6][7][8]15 The knees were affected in 11 out of 27 patients (40.7%). The predilection for knee tuberculous arthritis may be due to the vulnerability of the knees to trauma, and the wide prevalence of knee osteoarthritis.…”

“…But despite these, musculoskeletal TB is still uncommon and accounts for only 1%-5% of all cases of TB. [2][3][4][5][6][7][8][9] Prior to the era of anti-tuberculous medications, skeletal TB was considered a disease primarily of children, and continues to be so in underdeveloped countries. However, in developed countries, the highest incidence of skeletal lesions is to be found in older adults rather than children.…”

Extraspinal Musculoskeletal Tuberculosis

“…Sarcoidosis may be polyarticular, but is rarely present as monoarthritis, which is intermittent and persistent. Tuberculin skin test (PPD) may be positive in more than 90% of patients with osteoarticular tuberculosis (Berney et al 1972;Halsey et al 1982;Kerri and Martini 1985;Lee et al 1995). The hemogram shows normal white cell count and mildly elevated ESR (Wang et al 2000).…”

Tuberculose refratária disseminada com acometimento do tendão bicipital em paciente imunocompetente

“…O comprometimento ósseo é predominante e a coluna vertebral é a região mais frequentemente acometida (6) . O envolvimento articular é ainda menos usual e, em 50 a 73%, ocorre nas articulações de carga, como quadril e joelho (7)(8)(9) . O ombro raramente é acometido (6,7) .…”