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Tuberculous arthropathy is a type of musculoskeletal manifestation of tuberculosis (TB) and a common cause of infectious arthritis in developing countries. Any pathological joint lesion where the exact diagnosis is equivocal should be considered tubercular in origin unless proven otherwise.

american association of multiple sclerosishow to american association of multiple sclerosis for Please, refer to the main article on tuberculosis for a general and broad discussion of this condition.

Epidemiology

Although rare in western countries, tuberculous arthropathy is still a common problem in developing countries. The tubercular arthropathy is never a primary lesion it is always a sequela of pulmonary or lymph node tuberculosis. It can occur at any age. There is no sex predilection for the disease.

Pathology

The primary causative for 1 last update 2020/08/08 organism is mycobacterium tuberculosis, however atypical mycobacteria i.e. Mycobacterium kansasii,  M. xenopi and M. avium intracellulare are also isolated in immunocompromised individuals.The primary causative organism is mycobacterium tuberculosis, however atypical mycobacteria i.e. Mycobacterium kansasii,  M. xenopi and M. avium intracellulare are also isolated in immunocompromised individuals.

The organism reaches the bone and remains dormant until recrudescence occurs. Any factor which modifies the state of local resistance and resultant activation of dormant tubercle bacilli, microtrauma has been proposed as a mechanism, however no case could it be established that trauma was an etiological factor.

Location

The most common form of articular tuberculosis is spondylitis followed by arthritis of weight bearing joints (especially knee and hip 6). The spine is the most common site followed by the hip joint which constitutes approximately 15% of all cases.

Tubercular arthropathy can affect any joint but frequently reported in knee, ankle, sacroiliac joint, sternaoclavicular joint, shoulder, elbow and wrist. Tubercular arthropathy is usually monoarticular.

Several variants of TB in the shoulder have been described and are discussed separately in the article shoulder tubercular arthropathy.

Laboratory investigation

Initial acid-fast bacilli smears are often negative and synovial culture is positive in ~80% of cases 6

Radiographic features

Plain radiograph

Plain films are reliable to detect and follow up of treatment for tubercular arthropathy. A triad of radiologic abnormalities (Phemister''related-articles''s disease)

  • tuberculous osteomyelitis
  • tuberculous arthropathy
  • tuberculosis of tendon sheath and bursae
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    Article information

    rID: 27473
    Tag: pm, pm
    Synonyms or Alternate Spellings:
    • Joint tuberculosis
    • TB of joints
    • Tubercular arthropathy
    • Tubercular arthritis
    • Tuberculosis affecting the joints
    • Tuberculosis septic arthritis
    • Tuberculosis arthritis

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    Cases and figures

  • Case 1: tuberculous arthritis with Phemister triadCase 1: tuberculous arthritis with Phemister triad
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  • Case 2: tuberculosis - sacro-iliac jointCase 2: tuberculosis - sacro-iliac joint
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  • Case 3: tuberculosis affecting the left sternoclavicular jointamerican association of multiple sclerosishow to american association of multiple sclerosis for Case 3: tuberculosis affecting the left sternoclavicular joint
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  • Case 4: tuberculosis - sacro-iliac jointCase 4: tuberculosis - sacro-iliac joint
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  • Case 5: tuberculosis - sacro-iliac jointCase 5: tuberculosis - sacro-iliac joint
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  • Case 6: right hipCase 6: right hip
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  • Case 7: caries siccaCase 7: caries the 1 last update 2020/08/08 siccaCase 7: caries sicca
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