Radiographic findings of extremity tuberculosis in childhood: back to the future?

Since 1985, there has been an increase in the incidence of skeletal tuberculosis. Although this recent increase may prove to be temporary, familiarity with the protein manifestations of the disease is essential. The authors studied radiographs of 45 children in whom tuberculosis of the extremities had been diagnosed between 1937 and July 1991. Disease involved the hip in 18 cases; the knee in 17; the ankle in five; the shoulder in two; the midfoot in two; and the elbow, wrist, and hands in one each. Radiographic findings included joint effusion, periarticular osteopenia, joint space narrowing, cortical irregularity, lytic lesions, periosteal new bone formation, and advanced epiphyseal maturity. When the hip was involved, subluxation was a common finding. There is no single pathognomonic finding with which to make the diagnosis of skeletal tuberculosis. Clinical information may be helpful.