Diagnostic Challenges in Patients with Osteoarticular Tuberculosis in Mexico: Case Series

Abstract

Introduction: Osteoarticular tuberculosis poses a significant diagnostic and therapeutic challenge in developing countries, where the absence of molecular tools demands reliance on clinical suspicion and histopathological findings for diagnoses. Here, we present a compilation of case studies on osteoarticular tuberculosis for academic reference and support to aid primary care physicians in providing the best possible patient care. Methods: Retrospective analysis of cases diagnosed with osteoarticular tuberculosis through biopsy from 2010 to 2020 at a Mexican Traumatology and Orthopedics Hospital, examined using descriptive statistics. Results: Thirty-three patients were registered: 23 men (70%) and 10 women (30%). The most affected regions included the spine in 28 cases (84%), the hip in 3 (9%), and the elbow and sternoclavicular joints in 1 case each. The main clinical manifestations were paravertebral abscesses in 16 patients (48%), discitis in 12 (36%) and arthritis in 5 (15%), while the primary associated diseases were immunosuppression in 8 cases (24%), 2 cases with hepatitis (6%) and 3 with hypertension (9%). Discussion: Tuberculosis is endemic in Mexico, similar to other developing countries, with numerous reported cases of osteoarticular tuberculosis. This study highlights the importance of using alternative diagnostic tools when molecular tests and cultures are not accessible to general practitioners and orthopedic physicians who treat patients with clinical suspicion of osteoarticular tuberculosis.