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Musculoskeletal Tuberculosis.

Michael K Leonard1, Henry M Blumberg2

  • 1Division of Infectious Diseases, Carolinas HealthCare System, Charlotte, NC 28209.

Microbiology Spectrum
|April 15, 2017
PubMed
Summary
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Musculoskeletal tuberculosis (TB) is a significant extrapulmonary TB form, often presenting subtly. Early diagnosis using advanced imaging and prompt treatment with rifampin-based regimens are crucial for better outcomes in bone and joint TB.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Radiology

Background:

  • Musculoskeletal tuberculosis (TB) comprises 10% of extrapulmonary TB cases in the US.
  • Vertebral involvement (Pott's disease) is the most common skeletal TB manifestation.
  • Diagnosis can be delayed due to insidious onset and lack of pulmonary symptoms.

Purpose of the Study:

  • To highlight the diagnostic challenges and importance of early detection in musculoskeletal TB.
  • To emphasize the role of advanced imaging and microbiological confirmation.
  • To review current treatment recommendations for musculoskeletal TB.

Main Methods:

  • Review of clinical presentations and diagnostic approaches for musculoskeletal TB.
  • Discussion of the utility of MRI and CT scans in diagnosis.

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  • Emphasis on obtaining specimens for culture and susceptibility testing.

    • Main Results:

    • Advanced imaging like MRI and CT improve diagnostic accuracy.
    • Definitive diagnosis relies on microbiological confirmation (culture of M. tuberculosis).
    • Drug-susceptible musculoskeletal TB treatment involves 6-9 months of rifampin-based regimens.

    Conclusions:

    • Early diagnosis of musculoskeletal TB is vital to prevent deformity and improve patient outcomes.
    • Multimodality imaging and microbiological confirmation are key diagnostic pillars.
    • Standard rifampin-based treatment regimens are effective for drug-susceptible musculoskeletal TB.