| dc.description.abstract | Introduction: Among Extra-Pulmonary Tuberculosis (EPTB), extraspinal
tuberculosis arthritis is second to spine; hence a large number of
cases are visiting the medical facilities every year. However, diagnosing
and treating tuberculosis arthritis remain challenging since it affects
children and young adults. The aim of management is to have a painless,
mobile joint and return the anatomy of the joint as normal as possible.
Objective: In this article, we review clinical features and principles
of treatment of extra-spinal tuberculosis arthritis.
Patients and Methods: It is a retrospective study of all patients
followed for at least one joint tuberculosis confirmed bacteriologically
and/or histologically. We report 13 patients and among them one has
bilateral involvement.
Results: The mean follow-up time was 33 months. The most affected
joint was the hip which accounted for seven cases and among them one
has bilateral involvement, followed by the knee joint (three cases). The
shoulder, elbow, wrist and ankle joints accounted for one case each. All
cases were diagnosed by culture or biopsy, or both. All patients received
anti-tuberculosis chemotherapy in accordance with the National
protocol. Surgery was performed depending on the joint involved and
the radiological and clinical features. We performed three Total Hip
Replacement (THR) in two patients, nine debridements associated in
one patient with arthrodesis of the ankle joint and immobilization in
the reminder of cases. The mean follow-up time of 11 patients was 43
months while two patients disappeared. The anatomical and functional
results were excellent in cases of THR, however there was a limited
range of motion in conservative treatment.
Discussion: Tuberculosis arthritis remains a major health problem
worldwide and it can impair the joint functions. There is usually long
delayed consultation of patients thus challenging treatment. The THR is
often required as a therapeutic option under circumstances to deal with
complications or sequelae arising from the disease. | en_US |
