Osteonecrosis of the hip in sickle-cell disease associated with tuberculous arthritis

Varango, G.; Bamba, I.; Kodo, M; Dao, Ashley M.; Lambin, Y

doi:10.1007/s002640050283

Cited by 16 publications

(6 citation statements)

References 8 publications

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“…Patients usually have mild, local and constitutional symptoms. 10 Our patient had acute progressive hip pain in a few weeks, without any constitutional symptoms. X-rays show rapid collapse of the femoral head, but was still likely characteristic of those of osteonecrosis X-rays.…”

Section: Discussionmentioning

confidence: 64%

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Tubercular arthritis presenting as osteonecrosis of the femoral head: A case report

Nawatthakul

Yuenyongviwat

2020

SAGE Open Medical Case Reports

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A tuberculosis hip that presents as osteonecrosis of the femoral head is an extremely rare condition. There are no previous reports of this condition, and there is no consensus on the method of total hip arthroplasty for this group of patients. We present a case of a 72-year-old man who had clinical gradual hip pain in both hips for 1 year. He was diagnosed with post-collapsed osteonecrosis of the femoral head in both hips and was scheduled for total hip arthroplasty of the left hip. During his clinical follow-up, he suddenly experienced excruciating acute pain. Investigation to rule out infection was positive for only C-reactive proteins, but his synovial fluid work-up was negative. An intraoperative finding revealed that there was collapse of the femoral head with eroded acetabular cartilage and rice body–like synovitis. Total hip arthroplasty was performed, and the tissue was sent for diagnosis. Tissue acid-fast bacilli were positive, so the patient received anti-tuberculosis drugs for 9 months, with no recurrent infection. Tuberculosis arthritis presenting as osteonecrosis of the femoral head is a complex condition that is difficult to diagnose due to the radiographic pictures of femoral head collapse and arthritic change being similar in both diseases. Acute pain onset with rapid collapse of the femoral head should be a consideration or suspect for this infectious condition. Hence, investigation to rule out infection is important. Anti-tuberculosis drugs are the standard treatment for early or advanced arthritis, and one-stage or two-stage total hip arthroplasty is the choice of treatment for advanced arthritis.

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Section: Discussionmentioning

confidence: 64%

“…If unable to perform adequate curettage and debridement, or sinus tract occurs, two-stage THA is recommended by most authors. 10,12–14 Intraoperatively, our case revealed rice body–like synovitis. The synovial fluid was debrided and sent for microbiology study, including samples of the femoral head.…”

Section: Discussionmentioning

confidence: 65%

Tubercular arthritis presenting as osteonecrosis of the femoral head: A case report

Nawatthakul

Yuenyongviwat

2020

SAGE Open Medical Case Reports

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“…The initial role of surgery is both diagnostic, and later therapeutic [28][29][30][31][32]. Initially a biopsy is done to provide samples for synovial fluid analysis and synovial tissue for histo-pathologic evaluation.…”

Section: Surgical Treatment Options Tissue Biopsy Joint Drainage Andmentioning

confidence: 99%

Diagnosis and The Surgical Management of Hip and Knee Mycobacterium Tuberculous Arthritis

MbChb¹

2019

Surg Res

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Tuberculous (TB) arthritis accounts for 1-3 percent off all the tuberculosis cases globally. Extra-pulmonary TB affects most commonly the spine followed by hips and knees. The diagnosis of knee Tuberculosis can be challenging especially in patients with no obvious pulmonary disease or discharging sinuses. The medical management of osteoarticular tuberculosis is usually augmented by various surgical interventions for ideal outcomes. The role of surgery is both diagnostic, and reconstructive. The diagnosis has however improved markedly with newer diagnostic modalities but for joint tuberculosis the histopathologic examination of the synovium with demonstration of caseating granulomas is the gold standard. The development of better diagnostic and therapeutic methods for TB arthritis have improved the outcomes despite resurgence in TB cases globally due to the association with Acquired Immunosuppression Syndrome (AIDS). As the strategies for the diagnosis improve the management of TB arthritis should as well be aimed at better functional outcomes. For osteoarticular tuberculosis the ultimate aim of treatment should be to restore joint function and mobility with minimal disability.

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“…When tubercular tenosynovitis and arthritis are complicated by a secondary infection such as Staphylococcus aureus presents, they result in accelerated joint destruction associated with severe systemic features [14]. Joint tissue necrosis secondary to other diseases, as in the cases of osteonecrosis of the joints due to sickle cell disease and chondrocalcinosis may predispose an individual to tubercular infection [15,16].…”

Section: Introductionmentioning

confidence: 99%

Updated Diagnosis and Management of Osteoarticular Tuberculo

Chen¹

2014

ETS

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Background Tuberculosis (TB) of the osteoarticular system usually manifests as osteomyelitis and joint arthritis. The diagnosis of TB arthritis is often delayed due to the lack of awareness, insidious onset, lack of characteristic early radiographic findings and, often, lack of constitutional or pulmonary involvement. The purpose of this review is to provide an update on the diagnostic and therapeutic recommendations for TB arthritis. Methods The literature from a range of sources was reviewed and synthesized to provide an overview of contemporary approaches for the diagnosis and management of TB arthritis. Results This review summarizes the clinical, radiological, bacteriological, immunological, synovial fluid examination, and synovial biopsy approaches used in the diagnosis of TB arthritis. We also summarize the updated guideline for the treatment of TB arthritis. Conclusion Intense current and previous efforts into diagnostic, therapeutic, and preventive interventions have focused on pulmonary TB in adults, but TB arthritis has been relatively neglected. The development of better diagnostic and therapeutic methods for TB arthritis remains a significant challenge. As the strategies for the diagnosis and management of TB arthritis improve and the knowledge base increases, the implementation of these strategies will be crucial.

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Osteonecrosis of the hip in sickle-cell disease associated with tuberculous arthritis

Cited by 16 publications

References 8 publications

Tubercular arthritis presenting as osteonecrosis of the femoral head: A case report

Tubercular arthritis presenting as osteonecrosis of the femoral head: A case report

Diagnosis and The Surgical Management of Hip and Knee Mycobacterium Tuberculous Arthritis

Updated Diagnosis and Management of Osteoarticular Tuberculo

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