Bone & Joint Tuberculosis Flashcards

1
Q

What are the different classifications of a bone/joint tuberculosis lesion?

A

Extra-articular (epiphyseal/bones with haemodynamic marrow)
Intra-articular (large joints)
Vertebral body

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2
Q

What are the clinical features of a bone/joint tuberculosis?

A
Insidious onset & general ill health
Contact with TB
Pain (especially at night), swelling, loss of weight
Low grade pyrexia
Joint swelling 
Decrease ROM
Ankylosis
Deformity
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3
Q

What investigations should be performed if you suspect a bone/joint tuberculosis?

A
FBC, ESR
Mantoux test
Sputum/urine culture
X-ray
- soft tissue swelling
- periarticular osteopaenia
- articular space narrowing
Joint aspiration and biopsy
- AAFB identified in 10-20%
- culture +ve in 50% of cases
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4
Q

What are the differential diagnoses for a bone/joint tuberculosis?

A
Transient synovitis
Monoarticular RA
Haemorrhagic arthritis
Pyogenic arthritis
Tumour
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5
Q

What does osteopaenia mean?

A

Weakened bones that haven’t reached the stage of osteoporosis yet - like a halfway point between osteoporosis and normal bones

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6
Q

What is the treatment for bone/joint tuberculosis?

A

Chemotherapy
- initially rifampicin, isoniazid and ethambutol for 8 weeks
- then rifampicin and isoniazid for 6-12 months
Rest and splintage
Operative drainage rarely necessary

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