[Ostearticular tuberculosis. Study of 53 cases].
OBJECTIVE
To analyze the characteristics of bone and joint tuberculosis in a Spanish university hospital.


METHODS
Retrospective study (1984-2006) in a university hospital. All patients had microbiologically and/or histologically proved osteoarticular tuberculosis. Patients with clinical and radiological criteriae, positive tuberculin test responding to antituberculous treatment were not excluded despite negative cultures.


RESULTS
We attended 53 patients with osteoarticular tuberculosis (35 males/18 females; mean age: 52 years). Bone tuberculosis involved axial skeleton in 37 patients (71%), peripheral distribution in 12 (21%) and both locations in 4 (8%). Mean time to diagnosis was 8 months. Most common involved joints were knee and ankle. An extraarticular involvement was found in 12 patients (22%) and multifocal bone infection in 6 (11%). Risk factors were present in 22 patients (42%), and 15% were immigrants. The diagnosis was established by a positive culture in 40 cases (75%), and 33 (62%) had suggestive histology. Complications of tuberculosis included medullar compression (9.4%), abscess (12%) and fistulae (9.4%). Spine involvement required surgical intervention in 27% and peripheral involvement in 56%. Curation was achieved in 33 patients (62.3%), curation with secuelae in 19 cases (35.9%) and no consolidation of arthrodesis in one case.


CONCLUSIONS
Bone and joint tuberculosis is still common in our area and should be particularly considered in immigrants. Diagnosis delay is remarkable. Complications are present in one third of patients. Surgical treatment is often required.
Mateo
Lourdes
L
Servicio de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España. imateo.germanstrias@gencat.net
Ruiz Manzano
Juan
J
Olivé
Alejandro
A
Manterola
Joxe Mari
JM
Pérez
Ricard
R
Tena
Xavier
X
Prats
Marisol
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis*