Osteoarticular tuberculosis in a general hospital during the last decade

Ruiz, Guillermo García-Contreras; Rodríguez, Julio García; Güerri, M.L.; González, A.

doi:10.1046/j.1469-0691.2003.00671.x

Cited by 32 publications

(34 citation statements)

References 13 publications

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“…In our study a slight male predominance was seen. Clinically, pain is the commonest symptom, as encountered in our series [11,15]. Local swelling and sinuses can be seen in some cases [2]; one of our cases showed multiple sinuses.…”

Section: Discussionmentioning

confidence: 65%

“…Studies in different countries (Romania, Spain, Israel and Korea) have found 19, 26, 38 and 41 cases respectively, over a span of 10 years [8,9,12,15]. However, in a study at a busy teaching institute in Thailand, 99 cases of osteoarticular TB were found from the electronic data base during a 2 year period, which appears to be a very significant number of cases [11].…”

Section: Discussionmentioning

confidence: 99%

“…X-ray features have been found to be non-specific [1,13]. A high index of clinical suspicion is necessary [2,13,15] and in the series by Enache et al, 26% were clinically suspected of BJTB [8]. Delay in diagnosis can occur, especially in Caucasian population [18].…”

Section: Discussionmentioning

confidence: 99%

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Osteoarticular Tuberculosis-A Three Years’ Retrospective Study

Arathi¹

2013

JCDR

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Introduction: Extra pulmonary TB can be encountered in various organ systems, like lymph nodes, serous cavities, genitourinary tract, skeletal. Musculoskeletal TB can cause significant functional impairment. The clinical symptoms are variable, pain and swelling being common symptomatology. Investigations for suspected cases include radiological imaging, histopathological examination, bacteriological examination, and polymerase chain reaction.The mainstay of treatment is multidrug antitubercular chemotherapy. Aim:To study the cases of osteoarticular TB diagnosed on biopsy, to analyse the various microscopic patterns, results of microbiological investigations, correlate the clinical and radiological features and the response to ATT. Setting and Designs:A teaching tertiary medical institute in North India in catchment area, where prevalence of tuberculosis is high. A retrospective study of cases with a biopsy diagnosis of bone and/joint TB, retrieved from Histopathology section of Department of Pathology of the tertiary institute. Material and Methods:The study was retrospective and the data was collected for the preceding 3 years. The cases were retrieved from the records of the department of Pathology. A total of 16 cases were diagnosed as/suspected to be tuberculosis of bones and/joints. The clinical information were noted from the case files. Results of laboratory investigations along with relevant microbiologic investigations were noted. The biopsy samples were processed according to protocol. Ziehl-Neelsen stain to detect tubercle bacilli and PAS stain to rule out fungal infection were done. Microscopic features were noted. Results and Conclusion:Sixteen cases with a diagnosis of bone and/joint tuberculosis were found. The average age was 23.6 years. The most common presentation was pain and swelling. Knee joint was most commonly involved (7 cases) followed by spine and ankle (3 each). All the cases showed epithelioid granulomas which was necrotising in 11. AFB positivity was found only in 4 cases. ATT was started in 12 cases with a good response.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

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Osteoarticular Tuberculosis-A Three Years’ Retrospective Study

Arathi¹

2013

JCDR

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“…India accounts for nearly 20% of the total TB burden [2]. Of these, nearly 1-5% of cases have skeletal TB [3][4][5][6]. As TB is endemic in India, most orthopedic surgeons diagnose osteoarticular TB based on clinical and imaging findings only and initiate empirical anti-TB treatment.…”

Section: Introductionmentioning

confidence: 99%

Osteoarticular tuberculosis – diagnostic solutions in a disease endemic region

Agashe

Shenai

Mohrir

et al. 2009

J Infect Dev Ctries

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Background: We conducted a study of osteoarticular tuberculosis in patients from private and public settings in a disease endemic area. Our objective was to assess the role of mycobacterial culture and polymerase chain reaction (PCR) in the diagnosis of osteoarticular tuberculosis (TB) in settings where only clinical and imaging diagnosis form the basis for treatment. Methodology: Ninety-three consecutive specimens collected from clinically suspected patients of osteoarticular TB were screened for bacterial culture, mycobacterial culture and in-house nested PCR. In addition, specimens were examined by imaging and histopathology. Ten specimens collected from patients suffering from other bone diseases were included as negative controls. Results: Of the 93 clinically suspected TB patients, mycobacterial culture was positive for Mycobacterium tuberculosis (MTB) in 47 (51%) patients who were confirmed as definite TB cases. Of the remaining patients, 16 (17%) were diagnosed as probable, 19 (20%) as possible, and 11 (12%) as only clinically suspected TB cases. In-house nested PCR was positive in 65 (70%) cases. Fifteen patients were resistant to one or more anti-tuberculous drugs; twelve patients were multi-drug resistant, two of whom were extensively drug resistant. Conclusion: Mycobacterial cultures using liquid media with susceptibility should form the backbone of management of osteoarticular TB. Nested PCR enhances the sensitivity if performed in addition to culture.

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“…Among the 20 pus swab specimens which were negative by conventional staining and culture methods, PCR detected 4 positive cases (20%) of musculoskeletal tuberculosis. The findings related to poor yield of pus was also reported in the study conducted by Ganavalli et al 14 (25.8%) and Maurya et al 21 (27.65%), However, these findings were inconsistent from the study of Ruiz et al 11 (66.67%) and Prakash et al 13 (43.24%). In the study 14 USG guided pus aspirate samples were collected from suspected musculoskeletal tuberculosis patients, among them 1 (7%) was positive on smear microscopy and 6 (42.9%) were positive on LJ culture medium, however, PCR demonstrated 10 positive (71.4%) samples.…”

Section: Discussionmentioning

confidence: 73%

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

2020

IJMR

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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.

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Osteoarticular tuberculosis in a general hospital during the last decade

Abstract: A high degree of suspicion is still needed to avoid a delayed diagnosis that might complicate the outcome.

Cited by 32 publications

References 13 publications

Osteoarticular Tuberculosis-A Three Years’ Retrospective Study

Osteoarticular Tuberculosis-A Three Years’ Retrospective Study

Osteoarticular tuberculosis – diagnostic solutions in a disease endemic region

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

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