Musculoskeletal tuberculosis - A diagnostic dilemma: Clinico-bacteriological study among patients attending tertiary heath care centre in North Eastern India

Abstract

Introduction and Objectives: Clinicians consider musculoskeletal tuberculosis as diagnostic dilemma because diagnosis frequently gets delayed due to its varied clinical presentation, false negative results on smear microscopy and less sensitivity on culture methods (20-40%). The main objectives were to know the prevalence of musculoskeletal tuberculosis (TB) among patients attending NEIGRIHMS and to understand clinical bacteriological profile of musculoskeletal tuberculosis using conventional and molecular laboratory diagnostic methods. Materials and Methods:In this study, a total of fifty two clinical specimens like pus swab, ultrasonography guided (USG) pus aspiration, synovial fluid and bone biopsy of newly suspected musculoskeletal tuberculosis patients were evaluated for microscopy, culture and molecular detection of M. tuberculosis. Results:The study reveals prevalence of 46.2% musculoskeletal tuberculosis among the clinically suspected patients. The most commonly involved sites in suspected musculoskeletal tuberculosis were hip joint (23.1%). USG guided pus comprises only 26.9% of the samples collected, however, yield of M. tuberculosis from them were 71%. PCR detected the maximum number of cases of musculoskeletal tuberculosis 24 (46.2%) followed by culture method 13 (25%) and smear microscopy 1 (1.92%). Conclusion: This observation will help guiding clinicians in effective management of musculoskeletal tuberculosis cases because delayed diagnosis and treatment in musculoskeletal TB results in poor outcome.