Tuberculous osteomyelitis. A review of 125 cases

One hundred and twenty-five cases of tuberculous osteomyelitis have been observed by the authors since 1968. The site of the lesion and the clinical and radiological findings have been analysed. The importance of accurate diagnosis by bacteriological and histological investigation is emphasized. Pitfalls in the differential diagnosis with chronic haematogenous osteomyelitis are described. Treatment is by chemotherapy, and immobilization is useless. Operation was limited to the drainage of three large abscesses. A favourable response to chemotherapy was obtained in 92% of the 105 cases which were followed up. The role of a super-added pyogenic bone infection in 8 cases of persisting sinus after chemotherapy is discussed. Finally, the authors stress the importance of preventing the development of tuberculous arthritis by the correct diagnosis and treatment of juxta-articular tuberculous osteomyelitis.