Skeletal Tuberculosis- Review of Literature and Few case reports

Abstract

Extrapulmonary tuberculosis forms 15% of total tuberculosis in India. Skeletal tuberculosis which constitutes bone and joint tuberculosis, results from haematogenous spread from a pulmonary or other visceral or lymph node focus. Tuberculosis osteomyelitis was described by Nelatoo (1837); histologic morphology was given by Rokitansky (1884); tuberculosis nodule in a joint was seen by Koster (1869); and synovial tuberculosis by Volkmann (1879). Case No. 1: A case of Shoulder joint Tuberculosis which was relatively rare, was diagnosed in a middle aged farmer after taking proper history of pain and inability to move. He was investigated appropriately with radiological images and the case eventually responded to the anti-tuberculosis treatment. Case No. 2: A case of rib osteomyelitis was diagnosed when the young lady had only a complaint of pain in lower chest right side. The diagnosis of TB was reached after she had empyema and the same pus was tested for TB DNA. The decrease in pain and relieve of symptoms noticed after the initiation of treatment with Anti tuberculous treatment. She had surgical intervention for the same. Case No. 3 A young lady complained of pain and swelling in left wrist for a long duration. MRI showed bone marrow oedema in distal row of carpal bones with loss of articular cartilage and small erosion noted in trapezoid, base of metacarpal and capitates and base of third metacarpal joint. The diagnosis of tuberculosis was supported with Immunoglobulin Releasing Assay (IGRA) which was positive. Anti tuberculous drugs were given, and she responded well. Case No. 4 A middle aged man who was suffering from low back ache from 3 years had been diagnosed as Potts spine at L5 –S1 with the help of MRI spine. He was started with Anti tuberculosis drugs and he responded well. All the cases were also worked up for primary pulmonary involvement.