Tuberculosis Flashcards
1
Q
What is tuberculosis of bone and joints?
A
Bone TB is one of the extrapulmonary TBs that primarily affects the spine. It is an infective disease
2
Q
What are the classifications of bone Tuberculosis?
A
- Extra-articular (epiphyseal/bones with haemodynamic marrow)
- Intra-articular (large joints)
- Vertebral body
3
Q
Clinical features of tuberculosis?
A
- Insidious onset and general ill health
- Contact with TB
- Pain, swelling, loss of weight
- Low grade pyrexia
- Ankylosis
- Deformity
4
Q
What are the 3 steps of pathogenesis of Tuberculosis?
A
- Primary complex (in lung or gut)
- Secondary spread
- TB granuloma
5
Q
How does spinal tuberculosis present?
A
- Little pain
- Present with abscess or kyphosis
6
Q
On history/examination what would make you suspect TB as diagnosis?
A
- Long history
- Involvement of single joint
- Marked thickening of synovium
- Marked muscle wasting
- Periarticular osteoperosis
7
Q
What investigations would you carry out for TB?
A
- FBC, ESR
- Mantoux test
- Sputum, urine culture
- Xray: soft tissue swelling, periarticular osteopenia, articular space narrowing
- Joint aspiration and biopsy
8
Q
DDx for tuberculosis?
A
- Transient synovitis
- Monoarticular RA
- Haemorrhagic arthritis
- Pyogenic arthritis
- Tumour
9
Q
Tx for Tuberculosis?
A
Intitial: Rifampicin, Isoniazid, Ethambutol - 8 wks
Then: rifampicin and isoniazid for 6-12 months
Rest and splintage
Operative drainage if necessary
