Extra-Spinal Osteoarticular Tuberculosis: A Retrospective Analysis of 103 Cases

Many studies in the literature deals with epidemiology, diagnosis and management of spinal tuberculosis but there is scant amount of such data for extraspinal osteoarticular TB.

Demographic patient data like age, sex, bone and joint involved, side involved, duration of symptoms was noted. All suspected cases of extra-spinal musculoskeletal TB with positive acid-fast bacilli (AFB) staining or positive cartridge based nucleic acid amplification test (CBNAAT) or histopathological evidence of granulomatous infection and minimum 1 year follow up after completion of 12-month ATT were included in the study. Outcome evaluation was done on the basis of residual pain, range of motion of joint along with deformity of the affected part, if any.

A total of 103 patients (55 males, 48 females) were analyzed. The mean duration of treatment was 14.2±2.8 months. The mean age of the patients at presentation was 30.5±18.5 years. The most common site affected was the ankle joint followed by hip and knee. 95 cases (92.2%) were diagnosed by histopathological examination of synovial tissue or material obtained from core biopsy. 90 cases (87.3%) were treated conservatively on oral drugs only while 13 cases (12.7%) were treated operatively. Outcome after completion of ATT were graded as good in 46 (46.9%), fair and poor each in 26 patients (26.5%).

Extraspinal osteoarticular TB can be managed effectively by 12-month ATT if diagnosed early. Some cases with advanced arthritis can be salvaged with implant arthroplasty or arthrodesis under cover of ATT.