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Skeletal tuberculosis.

D Foley-Nolan1, R I Deegan, A A Foley-Nolan

  • 1Department of Rheumatology, Mater Misericordiae Hospital, Dublin.

Irish Medical Journal
|June 1, 1991
PubMed
Summary
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Skeletal tuberculosis, though uncommon, often presents with delayed diagnosis, particularly in the elderly. This study highlights frequent extraspinal involvement and concerns regarding underutilization of the Mantoux test.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Radiology

Background:

  • Skeletal tuberculosis is a rare manifestation of tuberculosis.
  • Diagnosis is often delayed, leading to prolonged patient suffering.
  • Previous studies have not emphasized extraspinal involvement as prominently.

Purpose of the Study:

  • To analyze the clinical characteristics of skeletal tuberculosis in adults.
  • To investigate the frequency of extraspinal involvement.
  • To identify diagnostic challenges and delays in skeletal tuberculosis cases.

Main Methods:

  • Retrospective review of 36 adult patients diagnosed with skeletal tuberculosis between 1977-1987.
  • Analysis of symptom duration, location of involvement, and diagnostic methods used.

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  • Comparison with existing literature on skeletal tuberculosis.

    • Main Results:

    • The study identified 36 adult cases of skeletal tuberculosis.
    • Extraspinal involvement was found to be more frequent than reported in other studies.
    • A significant delay in diagnosis was observed, averaging 10.79 months.
    • Underutilization of the Mantoux test was noted as a diagnostic concern.

    Conclusions:

    • Skeletal tuberculosis requires a high index of suspicion, especially in elderly patients with unexplained inflammatory arthritis.
    • Diagnostic delays suggest tuberculosis is not considered early enough.
    • Increased utilization of the Mantoux test could aid in earlier diagnosis and management.