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Published on: August 11, 2008
Multifocal osteoarticular tuberculosis in children
Anil Agarwal1, Shariq Azam Khan, Nadeem Akhtar Qureshi
1Department of Orthopaedics, CNBC, Geeta Colony, Delhi, India. rachna_anila@yahoo.co.in
Journal of Orthopaedic Surgery (Hong Kong)
|December 21, 2011
Summary
Multifocal osteoarticular tuberculosis in children typically affects immunocompetent individuals, with appendicular sites being more common than axial. Standard multidrug therapy and nutritional support lead to good outcomes, though residual joint issues can occur.
Area of Science:
- Pediatric infectious diseases
- Musculoskeletal infections
- Tuberculosis research
Background:
- Multifocal osteoarticular tuberculosis is a rare but serious condition in children.
- Understanding its clinical presentation and treatment outcomes is crucial for effective management.
Purpose of the Study:
- To review the clinical characteristics and treatment outcomes of 16 children diagnosed with multifocal osteoarticular tuberculosis.
- To evaluate the efficacy of standard antitubercular chemotherapy in this pediatric population.
Main Methods:
- Retrospective review of medical records for 16 children (7 girls, 9 boys) aged 1-14 years with confirmed multifocal osteoarticular tuberculosis.
- Diagnostic workup included hematological tests and comprehensive radiographic imaging (chest, spine, pelvis, joints, hands, feet).
- Treatment involved a 12-month standard four-drug antitubercular chemotherapy regimen supplemented with nutritional advice.
Main Results:
- All patients were immunocompetent; pain and swelling were primary symptoms, with fever being uncommon.
- Appendicular skeletal involvement (hands, feet) was more frequent than axial (spine).
- Complete healing was achieved within one year of chemotherapy for all patients, with residual joint limitations noted in severe cases.
Conclusions:
- Multifocal osteoarticular tuberculosis in children predominantly affects immunocompetent individuals, with a higher incidence of appendicular than axial involvement.
- Standard multidrug antitubercular therapy, alongside nutritional support, is effective in achieving favorable outcomes.
- Early diagnosis and consistent treatment are key, though advanced cases may lead to lasting joint sequelae.
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