Tuberculosis of the shoulder joint

Kapukaya, Ahmet; Subaşı, Mehmet; Bükte, Yaşar; Gür, Ali; Tüzüner, Tolga; Kilnc, Nihal

doi:10.1016/j.jbspin.2005.03.015

Cited by 35 publications

(39 citation statements)

References 22 publications

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“…5,6 Usually superinfection is a complication of a draining sinus. 4 However our patient did not have any draining sinus. Because of her depressed immunosuppressed status the beta haemolytic streptococcus group B in her blood seeded in her left shoulder that already had underlying tuberculosis and tipped her into diabetic ketoacidosis.…”

Section: Discussionmentioning

confidence: 57%

“…6 Septic arthritis of the glenohumeral articulation is a rare entity and its diagnosis is difficult particularly with concomitant tuberculosis. The probability of septic arthritis increases in the presence of immunosuppressant conditions like rheumatoid arthritis, 4 hepatitis C and diabetes mellitus. We report the first case of group B beta haemolytic streptococcal septic glenohumeral arthritis with underlying tuberculosis and a contiguous proximal arm abscess in a middle aged lady.…”

Section: Introductionmentioning

confidence: 99%

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Glenohumeral tuberculous arthritis complicated with beta haemolytic streptococcus: An extraordinary rare association: A case report

Rashid

Sarwar

Akhtar

et al. 2012

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Glenohumeral tuberculous arthritis complicated with beta haemolytic streptococcus: An extraordinary rare association: A case report

Rashid

Sarwar

Akhtar

et al. 2012

International Journal of Surgery Case Reports

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“…Quanto à confirmação do diagnóstico, uma vez que as características clínicas são inespecíficas, os exames complementares têm grande valor. Exames laboratoriais costumam ser normais, exceto pela VHS, que está geralmente elevada (22,24) . Assim como no caso relatado, a maioria dos pacientes tem teste tuberculínico (purified protein derivatives -PPD) positivo (17) , embora este exame tenha pouco valor, especialmente em áreas de alta prevalência da tuberculose (4,23) .…”

Section: Discussionunclassified

“…A ocorrência de tuberculose extrapulmonar parece decorrer da reativação de focos latentes, após uma primoinfecção (27) . A maioria das formas articulares ocorre devido à extensão a partir de um foco ósseo adjacente, embora também possa ocorrer infecção hematogênica direta da membrana sinovial (24) . O acometimento de tendões também parece ocorrer mais provavelmente por contiguidade (18) .…”

Section: Discussionunclassified

Tuberculose refratária disseminada com acometimento do tendão bicipital em paciente imunocompetente

Oliveira¹,

Schiefer²,

Silva³

et al. 2009

Rev. bras. ortop.

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RESUMOObjetivo: Relatar um caso raro de tuberculose disseminada em paciente imunocompetente, que evoluiu, durante o tratamento medicamentoso padrão, com envolvimento do tendão da porção longa do bíceps e da articulação do ombro. Métodos: À primeira avaliação, o diagnóstico correto não foi feito e o paciente foi tratado com fisioterapia para tendinopatia do manguito rotador. Entretanto, apresentou rápida formação de massa na região anterior do terço proximal do braço e piora da dor. A punção da massa revelou líquido amarelado, cuja análise laboratorial confirmou tratar-se de infecção por M. tuberculosis. Resultados: O paciente foi tratado com desbridamento cirúrgico e troca do esquema medicamentoso e evoluiu com resolução do quadro infeccioso e melhora completa da função do ombro direito. Conclusão: Devido a sua alta prevalência no Brasil, a tuberculose deve sempre ser considerada no diagnóstico diferencial dos casos de comprometimento crônico e progressivo das articulações, ossos, músculos, tendões e bursas, mesmo em indivíduos imunocompetentes. Descritores -

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“…In the present case report, three subacromial injections proved detrimental to outcome, and this was exacerbated by a difficulty in recognizing TB. Shoulder TB is rare in developed countries and has been described as a diagnostic challenge; often misdiagnosed as frozen shoulder or impingement syndrome [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Presentation of Mycobacterium tuberculosis following subacromial corticosteroid injection

et al. 2013

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Subacromial corticosteroid injection is a common procedure performed in the shoulder clinic and septic arthritis is a recognized but rare complication. The present case highlights the poor outcome of a patient with a family history of tuberculosis (TB) who underwent three corticosteroid injections to her right shoulder. After months of worsening symptoms, her first presentation of TB manifested as a deep cavity in the shoulder. This report identifies the challenges in the diagnosis and management of shoulder TB and provides an insight into the potential scope of the problem in Britain. INTRODUCTIONSubacromial corticosteroid injections are a well recognized and well practiced management option for shoulder pain secondary to arthritis and rotator cuff pathology [1]. Articular injections are contraindicated in those with active local infection and should be used with extreme caution in those with a previous history of tuberculosis (TB).Intra-articular TB is rare as the primary manifestation of Mycobacterium tuberculosis. A case report exists of a reactivation of pre-existing TB following intra-articular corticosteroid injections (IACI) to a knee [2]; primary manifestation of previously subclinical TB in a shoulder following corticosteroid injections has not been reported.Primary manifestation of tuberculosis has been seen in individuals undergoing total knee replacement and shoulder hemiarthroplasty [3,4]. These infections were more clearly associated with the prosthesis rather than steroid use. Both reports acknowledged that systemic immunosuppression contributed to the periprosthetic TB, with the presence of metalwork being a compounding factor [3,4].The affects of IACI are primarily local but also mildly systemic; two case reports identify reactivation of latent TB following IACI [5,6]. Intra-articular etanercept has also reactivated pulmonary TB [7]. Prolonged immunosuppression in the presence of TB can be rapidly destructive. In the present case report, three subacromial injections proved detrimental to outcome, and this was exacerbated by a difficulty in recognizing TB. Shoulder TB is rare in developed countries and has been described as a diagnostic challenge; often misdiagnosed as frozen shoulder or impingement syndrome [8][9][10].

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Tuberculosis of the shoulder joint

Cited by 35 publications

References 22 publications

Glenohumeral tuberculous arthritis complicated with beta haemolytic streptococcus: An extraordinary rare association: A case report

Glenohumeral tuberculous arthritis complicated with beta haemolytic streptococcus: An extraordinary rare association: A case report

Tuberculose refratária disseminada com acometimento do tendão bicipital em paciente imunocompetente

Presentation of Mycobacterium tuberculosis following subacromial corticosteroid injection

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