Tuberculous osteoarthritis of the wrist about three observations and review of the literature

Abstract

Objectives: To determine the therapeutic modalities and to specify the evolution of the treatment of osteo-articular tuberculosis of the wrist. Introduction: Osteoarticular tuberculosis is rare 3 to 5% of all localizations by BK. Their diagnosis is often late. Patients and methods: This was a retrospective study continued from January 2010 to November 2017. 3 patients, 2 men and 1 woman aged 39.66 years (range 19 to 65 years) were involved. The average consultation time was 17 months (range 3 to 24 months). For both patients, it was isolated osteoarthritis of the wrist and for the 3rd, it was associated with another location. Two patients presented a concept of tuberculous contagion and the other a pulmonary tuberculosis associated with Pott's disease. The function was evaluated according to the Mayo Wrist score and the winding of the fingers. Results: The treatment consisted of debridement in all cases. In all our patients the pathological examination found an epitio-gigantocellular granuloma with caseous necrosis. Anti-tuberculosis chemotherapy was instituted in all patients for a period of 6 months (n = 2, one of which is still in treatment), 9 months (n = 1). At the average follow-up of 5 years in the 2 (extremes 2 and 8 years), we did not observe a recurrence. The function was good the 2 cases that finished their treatment with a complete winding of the fingers. Conclusion: Treatment is based on debridement and antituberculous chemotherapy. Applied early, it provides excellent results.