title: Tuberculous arthritis--a fourteen-year experience at a tertiary teaching hospital in Taiwan.
abstract: OBJECTIVE
  To characterize the clinical and microbiological features of tuberculous arthritis and to clarify the factors affecting treatment outcome.
  
  
  METHODS
  We retrospectively reviewed 51 adult patients with a diagnosis of tuberculous arthritis at Chang Gung Memorial Hospital-Linkou over a 14-year period.
  
  
  RESULTS
  There were 35 males and 16 females with a mean age of 58.9 years (range, 32 to 89 years). The mean duration of symptoms and signs before diagnosis was 25.4 months (range, 0.25 to 180 months). Joint pain (96.1%) and swelling (90.2%) were two major presentations. Forty five (88.2%) patients had monoarthritis. Knee (26.7%) was the most frequently involved one. Twenty six (51.0%) patients had roentgenologic evidence of pulmonary tuberculosis (TB). Forty three patients (84.3%) had positive TB culture of synovial fluid and/or tissue. Of which, 27 (63%) had positive acid-fast bacillus smear. Twenty five patients had sputum for mycobacterial smear and culture, and 17 of them had positive TB culture. Thirty six patients received post-treatment follow-up for 3 to 110 months. Among them, 8 had relapses and 28 had treatment success. Compared the relapse to the success, the former had a higher ratio of drug resistant strains (odds ratio, 7.8; 95% confidence interval, 1.025-59.337; p=0.047) and had a longer treatment duration (22.0 +/- 4.4 vs 13.2 +/- 4.1 months; p=0.001).
  
  
  CONCLUSIONS
  Tuberculous arthritis often occurred in elderly people with male predominance. Drug resistant strain may cause a relapse of tuberculous arthritis, which may result in longer treatment duration. Routine chest X-ray and sputum for mycobacterial smear and culture could be necessary to find concurrent pulmonary TB.
authors: Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors: Tsung-Yu
authors: TY
authors: Huang
authors: Ting-Shu
authors: TS
authors: Wu
authors: Chien-Chang
authors: CC
authors: Yang
authors: Ping-Cherng
authors: PC
authors: Chiang
authors: Kuang-Hui
authors: KH
authors: Yu
authors: Ming-Hsun
authors: MH
authors: Lee
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D024881:Drug Resistance, Bacterial; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy