title: Tuberculosis of the elbow: A clinicoradiological analysis.
abstract: BACKGROUND
  The incidence of Tuberculosis (TB) of elbow is 2-5% of all skeletal locations. Most reports of TB elbow have focused attention on the diagnosis. The management options and classification has been missing. We present a retrospective clinicoradiological analysis of 38 cases (40 elbows) of TB of elbow joint.
  
  
  METHODS
  The patients presented with pain, swelling and loss of motion. Two cases had bilateral involvement. The average delay between onset of symptoms and presentation was 8 months. The elbows were classified according to modified Martini's radiological classification, which distinguishes between osseous lesions close to joint line (e.g. coronoid, condyles) and lesions away from the joint line (e.g. epicondyles, olecranon). We modified the classification to subdivide into para-articular bony lesions that had invaded the joint and those that were threatening to invade joint. All patients received antitubercular chemotherapy and immobilization in above-elbow plaster slab for 4-8 weeks. Twenty patients underwent surgical interventions (synovectomy, intraarticular debridement).
  
  
  RESULTS
  The average followup period was 5.3 years (range 1.5-14.2 years). The range of movement at final followup averaged 107° for stage 2, 90° for stage 3A, 47° for stage 3B and 32° for stage 4. Range of supination and pronation was less satisfactory as compared to flexion and extension and all elbows with bony involvement had less than 90° arc of supination and pronation.
  
  
  CONCLUSIONS
  Surgical intervention could appreciably alter the outcome especially in patients with extra-articular involvement close to the joint. We have classified this subgroup separately.
authors.affiliation: Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Dhillon
authors.forename: Akshay
authors.initials: A
authors.lastname: Goel
authors.forename: Sharad
authors.initials: S
authors.lastname: Prabhakar
authors.forename: Sameer
authors.initials: S
authors.lastname: Aggarwal
authors.forename: Vikas
authors.initials: V
authors.lastname: Bachhal