Musculoskeletal manifestations in Tuberculosis

IF 4.8 2区医学 Q1 RHEUMATOLOGY Best Practice & Research in Clinical Rheumatology Pub Date : 2025-05-01 Epub Date: 2025-03-14 DOI:10.1016/j.berh.2025.102057

Ramaswamy Subramanian, Shiva Prasad, Mahabaleshwar Mamadapur

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Abstract

Musculoskeletal Tuberculosis (TB) affects the bones, joints and soft tissues and accounts for 1–3 % of TB cases worldwide. The onset of symptoms is usually insidious and nonspecific. It may lead to irreversible joint damage, deformities or neurological manifestations necessitating surgical and rehabilitative corrections due to delayed diagnosis and prolonged latency in the initiation of definitive medical treatment. The axial skeleton, particularly the thoracic and lumbar regions, is the most commonly involved site, followed by the hips and knees in peripheral joints. Given the rising prevalence of TB in developing countries and the emergence of drug-resistant strains, understanding musculoskeletal TB's pathophysiology, clinical manifestations, and management strategies remains critical for improving patient outcomes. In addition, non-tuberculous mycobacterial infections, para-infectious manifestation, and achieving adequate disease control in a setting of immune-mediated inflammatory disorders pose significant diagnostic and therapeutic challenges.

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肺结核的肌肉骨骼表现。

肌肉骨骼结核（TB）影响骨骼、关节和软组织，占全世界结核病病例的1- 3%。症状的发作通常是隐匿的和非特异性的。它可能导致不可逆转的关节损伤、畸形或神经症状，由于诊断延误和开始最终医疗的时间过长，需要手术和康复矫正。中轴骨骼，特别是胸椎和腰椎，是最常见的受累部位，其次是髋关节和膝关节周围关节。鉴于发展中国家结核病发病率不断上升以及耐药菌株的出现，了解肌肉骨骼结核的病理生理学、临床表现和管理策略对于改善患者预后仍然至关重要。此外，在免疫介导的炎症性疾病中，非结核性分枝杆菌感染、准感染性表现以及实现适当的疾病控制构成了重大的诊断和治疗挑战。

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来源期刊

Best Practice & Research in Clinical Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

0.00%

发文量

审稿时长

27 days

期刊介绍： Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions. Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science. The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.

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