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Bone and joint tuberculosis--a 10-year review

I Grosskopf¹, A Ben David, G Charach

¹Department of Medicine C, Tel Aviv Medical Center (Ichilov Hospital), Tel-Hashomer, Israel.

Israel Journal of Medical Sciences

|April 1, 1994

Summary

Bone and joint tuberculosis (BJT) incidence is decreasing. A 10-year review revealed older patients, low spinal involvement, and diagnostic delays due to subtle symptoms and incomplete workups in Israel.

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Area of Science:

Orthopedics
Infectious Diseases
Public Health

Background:

Antituberculous therapy has reduced bone and joint tuberculosis (BJT) incidence.
Understanding the current presentation of BJT is crucial for timely diagnosis and management.

Purpose of the Study:

To evaluate the evolving clinical presentation of BJT over a 10-year period.
To identify challenges in diagnosing and managing BJT in a contemporary setting.

Main Methods:

A retrospective 10-year review of BJT cases across 7 general hospitals in Israel.
Inclusion based on strict diagnostic criteria for extrapulmonary tuberculosis.

Main Results:

Median patient age was 63 years, higher than anticipated.

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Spinal involvement was infrequent; extremity involvement showed right-sided predominance.

Deep-seated infections often lacked overt symptoms, leading to diagnostic delays.

Incomplete workups and physician unawareness contributed to delayed diagnosis.

A notable proportion of patients received inappropriate surgical interventions.

Conclusions:

BJT presentation is evolving, with older patients and less common spinal involvement.
Diagnostic delays persist due to subtle clinical signs and diagnostic challenges.
Management requires careful consideration to avoid unnecessary surgical procedures.