Purpose
Changes in the epidemiology of tuberculosis has lead to its increased incidence in industrialised nations [1].The resurgence of extrapulmonary tuberculosis can be ascribed tothe emergence of drug resistant strains and an increase in the number of immunocompromised individuals.In particular osteoarticular involvement has recently shown a marked rise and presently accounts for 10% of extrapulmonary tuberculosis [2].Extrapulmonary tuberculosis is one of the great mimics of medicine and can even masquerade as malignancy. The protean manifestations of musculoskeletal tuberculous infections have been well described [3].This can result...
Methods and Materials
50 proven patients of musculoskeletal tuberculosis were studied from June 2007 to Nov 2009 at our Institute.Nine of these patients showed up with unusual manifestations of osteoarticular tuberculosis.Imaging was done using plain radiography, multi slice CT and a 1.5 T MRI Scanner available in the institute. The time interval between the presentation of the patient and the investigation by various modalities was within 7 to 10 days. Subsequently patients were started on Anti tubercular treatment. Lab investigations including ESR and Mantoux test was done in...
Results
Five clinical syndromes of osteoarticular tuberculosis have been described. Spondylitis (50%) the most common clinical manifestation followed by peripheral arthritis (30%), osteomyelitis (19%), tenosynovitis, bursitis and Poncet disease (1%)[2].Unusual manifestations of Tuberculous spondylitisSpinal TB is an uncommon condition in developed nations and its symptoms are not so unique as to indicate the proper diagnosis.Spine is the most common site of musculoskeletal tuberculous infection and thoracolumbar region is the most commonly affected regionMajority of patients have two or more adjacent vertebrae affected at the time of...
Conclusion
Extra pulmonary tuberculosis, a condition whose resurgence can be ascribed to multi drug resistant strains, increase in the number of immunocompromised individuals, as well as immigrants from the developing world, as such is a difficult diagnosis to make. Further musculoskeletal tuberculosis is renowned for an ability to present in various locations and guises. Thus the diagnosis of osteoarticular tuberculosis is extremely difficult owing to uncommonness of the entity and clinical inexperience especially in the developed nations. Hence it is very essential for the treating clinician...
References
REFERENCES1.Cantwell MF, Snider DE, Cauthen GM, Onorato IM (1994). Epidemiology of tuberculosis in the United States. JAMA 272: 535-539.2.Iagnocco A, Coari G, Buzzi G, Guerrisi R, Valesini G (2003). Magnetic Resonance imaging of peripheral osteoarticular tuberculosis compared with sonography and standard radiographs. Rheumatol Int 23: 195-197.3.Sawlani V, Chandra T, Mishra RN, Aggarwal A, Jain UK, Gujral RB (2003) MRI features of Tuberculosis of peripheral joints. Clin Radiol 58 : 755-762.4.Spiegel DA, Singh GK, Banskota AK(2005) . Tuberculosis of the musculoskeletal system. Techniques in Orthopaedics 20...