TUBERCULOSIS OF THE APPENDICULAR BONES AN D JOINTS - A REVIEW OF 50 CASES

Osteoarticular tuberculosis of the limbs is still a common disease of which 50 cases seen between 1981 and 1992 are reviewed herein. There w ere 28 males and 22 females, and mean age was 32 years. A contact subj ect was identified in ten cases. Five patients had been treated for pu lmonary tuberculosis. Lesions predominated at the lower limbs (n=45), with the hip being the most commonly affected area (n=26). Pain was th e main reason for seeking medical advice. Plain films showed stage II and stage III lesions according to the David-Chausse classification in 44 cases. The diagnosis was confirmed by histologic examination of a biopsy specimen in 90% of cases. Antituberculous treatment for six to eighteen months ensured recovery in every case, although eight patient s had severe residual functional disability. A review of the literatur e demonstrated that the knee is commonly affected. Histologic examinat ion of a synovial membrane biopsy specimen ensures the diagnosis in 85 % of cases. Full recovery with a satisfactory functional outcome can b e achieved by early administration of either a short, six-month course of antituberculous agents or the conventional prolonged antituberculo us treatment.