Tuberculosis of hip: A current concept review

Area of Science:

• Orthopedics
• Infectious Diseases
• Radiology

Background:

• Tuberculosis (TB) of the hip is a significant clinical challenge, frequently presenting in advanced stages due to diagnostic delays.
• Early-stage hip TB poses diagnostic dilemmas, especially when plain X-rays are inconclusive.

Purpose of the Study:

• To highlight the importance of modern diagnostic modalities for early detection of hip tuberculosis.
• To discuss current treatment strategies emphasizing hip mobility and stability.

Main Methods:

• Utilizing advanced imaging like ultrasonography (USG) and magnetic resonance imaging (MRI) for hip joint evaluation.
• Employing USG-guided synovial fluid aspiration for polymerase chain reaction (PCR) and tissue diagnosis.
• Comparing treatment outcomes of joint debridement, skeletal traction, and mobilization exercises versus hip spica immobilization.

Main Results:

• Modern diagnostic tools offer improved detection compared to traditional clinicoradiological methods.
• Early diagnosis is crucial as plain X-rays often show changes only in moderately advanced disease.
• Treatments focusing on mobility and stability, such as debridement and exercises, may yield better results than immobilization.

Conclusions:

• Advanced diagnostic modalities are essential for timely diagnosis of hip tuberculosis.
• Treatment should prioritize hip mobility and stability.
• Total hip replacement is recommended for healed disease in selected cases, with caution advised for active disease pending long-term results.