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[Analysis of misdiagnosis of tuberculosis in the synovial sheath]
1Department of Orthopaedic, Second Affiliated Hospital of Sun Yat-sen University, Guangzhou 510120, China.
Objective:
To investigate the factors for misdiagnosis of tuberculosis in synovial sheath, and therefore to improve the early diagnosis of the disease.
Methods:
From January 1991 to December 2003, 15 cases of tuberculosis in the synovial sheath were treated using surgery and anti-tuberculous agents. The clinical features and the related factors for misdiagnosis were analyzed.
Results:
The duration from onset of symptom and sign to a final diagnosis was (16 +/- 10) months (range from 2 to 36 months). Twelve cases were misdiagnosed before surgery. All cases were followed up for 2.5 to 7 years without recurrence, except one case of systemic lupus erythematosus complicated with tuberculosis of the wrist and the ankle 1 month after operation.
Conclusion:
Lack of specific symptoms and signs, nonspecific radiological manifestations and over-dependence on laboratory examinations were the major factors responsible for early misdiagnosis.
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