Bone & Joint Tuberculosis Flashcards
What are the different classifications of a bone/joint tuberculosis lesion?
Extra-articular (epiphyseal/bones with haemodynamic marrow)
Intra-articular (large joints)
Vertebral body
What are the clinical features of a bone/joint tuberculosis?
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
What investigations should be performed if you suspect a bone/joint tuberculosis?
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
What are the differential diagnoses for a bone/joint tuberculosis?
Transient synovitis Monoarticular RA Haemorrhagic arthritis Pyogenic arthritis Tumour
What does osteopaenia mean?
Weakened bones that haven’t reached the stage of osteoporosis yet - like a halfway point between osteoporosis and normal bones
What is the treatment for bone/joint tuberculosis?
Chemotherapy
- initially rifampicin, isoniazid and ethambutol for 8 weeks
- then rifampicin and isoniazid for 6-12 months
Rest and splintage
Operative drainage rarely necessary