Osteoarticular tuberculosis in Central India: Changing epidemiological profile and emerging challenges

Area of Science:

• Orthopedics
• Infectious Diseases
• Public Health

Background:

• Osteoarticular tuberculosis (OATB) is a bone and joint manifestation of extrapulmonary tuberculosis (TB).
• Limited epidemiological data exists for skeletal TB in current literature and reports.
• Emerging atypical presentations necessitate ongoing surveillance of OATB epidemiology.

Purpose of the Study:

• To analyze the epidemiological trends of osteoarticular tuberculosis in Central India.
• To identify demographic patterns and common sites of OATB.
• To understand the burden and characteristics of OATB in the region.

Main Methods:

• An ambispective observational study over 5 years (2017-2021) at a tertiary care center.
• Analysis of demographic factors, lesion sites, and comorbidities in OATB patients.
• Statistical analysis using the Chi-square test for linear trend.

Main Results:

• 210 skeletal TB lesions were identified in 208 patients.
• OATB predominantly affected young adults, particularly females.
• Spinal lesions (especially lumbar spine) were most common (3x extraspinal); hip was the most frequent extraspinal site. Unusual sites included sternoclavicular joint and ischial tuberosity.

Conclusions:

• The incidence of OATB, notably spinal TB, appears to be increasing.
• Atypical OATB presentations require heightened clinical suspicion for timely diagnosis.
• The current approach to empirical antitubercular chemotherapy warrants review due to rising drug resistance concerns.