Epidemiological features of skeletal tuberculosis at an urban district tuberculosis centre

Skeletal tuberculosis is an important component of extra-pulmonary tuberculosis. It can lead to substantial morbidity and poses serious occupational and economic problem. We conducted a study in an urban District Tuberculosis Centre (DTC) to assess the burden and distribution of skeletal tuberculosis in the community. Our centre was catering to a population of 6-7 lakhs between 2007 and 2012. During this period, we treated 11,274 cases of tuberculosis. Out of these, 3086 (27.3%) were cases of extrapulmonary tuberculosis and 219 (1.94%) were cases of skeletal tuberculosis. Skeletal TB predominantly affects the young Indian population with incidence peaking in the second and third decades of life. 172 patients (78.5%) in our study were new cases. There were no drugs resistant (DRTB) skeletal TB cases till we concluded our study. Tuberculosis commonly involves joints more than long bones. The spinal column was the most commonly involved skeletal site affecting 62.6% of all cases. The rate of spinal TB in our study is much higher than that reported in literature. The high number of patients calls for close co-ordination between managing orthopaedic surgeons, treating physicians and DOT providers to ensure adequate patient care.