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Arthritis associated with tuberculosis.

A N Malaviya1, P P Kotwal

  • 1A&R Clinic for Arthritis and Rheumatism, Indian Spinal Injuries Centre, Vasant Kunj, New Delhi 110 070, India. anand_malaviya@yahoo.com

Best Practice & Research. Clinical Rheumatology
|June 6, 2003
PubMed
Summary
This summary is machine-generated.

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Tuberculosis (TB) affecting joints and bones is increasing globally. Early diagnosis of TB arthritis is crucial to prevent joint damage and ensure timely treatment with anti-TB drugs.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Rheumatology

Background:

  • Global resurgence of tuberculosis (TB) leading to increased extrapulmonary cases.
  • Joint and bone TB accounts for 10-11% of extrapulmonary TB, affecting 19-38 million worldwide.
  • TB arthritis often presents as monoarthritis of weight-bearing joints, but can mimic inflammatory arthritis.

Observation:

  • Diagnosis of joint and bone TB is frequently delayed in developed countries due to its low incidence.
  • Current diagnostic methods rely on time-consuming microbiological tests or invasive biopsies.
  • Isoniazid resistance is common, necessitating multi-drug regimens for initial treatment.

Findings:

  • TB arthritis commonly affects the hip or knee, but can present in multiple joints.

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  • Delayed diagnosis can lead to irreversible joint damage.
  • Effective treatment involves a combination of four anti-TB drugs for at least 9 months.

    • Implications:

    • Increased clinical suspicion for TB arthritis is needed to reduce diagnostic delays.
    • Prompt anti-TB therapy can prevent severe joint damage.
    • Surgical intervention is reserved for severe cases, including those with drug resistance or extensive destruction.