K. Benbouazza et al., PUBIC TUBERCULOUS OSTEOARTHRITIS - 2 CASE S, Revue de chirurgie orthopedique et reparatrice de l'appareil moteur, 83(7), 1997, pp. 670-672
Objective The authors report an exceptionnal site of tuberculous osteo
-articular infection which must be diagnosed before the destructive st
age. Observations Case I: a 21 years old woman presented an inflammato
ry pubic pain after a trauma with wheight loss of 4 kgs in 3 weeks, Sh
e presented also 2 satellite inguinal nodes. Erythrocyte sedimentation
rate (ESR) was elevated, X-rays showed an important osteolysis of the
left ischio-pubic rami, tuberculous skin test (TST) was positive, myc
obacterium tuberculosis (MT) could not be found neither in sputtum nor
in urine but the node biopsy showed the specific features of tubercul
osis Evolution under a 6 months antibiotic treatment was good. Case 2:
a 19 years old woman, with history of tuberculous contagion, presente
d in April 1996 cervical nodes and a month later inflammatory pubic an
d knee pain with wheight loss and vesperal sudation. ESR was elevated,
TST was phlyctenular, MT searching and HIV serology were negative. X
rays showed irregular osteolysis of the pubic symphysis, Scintigraphy
showed an increased fixation of pubis and left knee, Cervical nodes bi
opsy diagnosed tuberculosis. Evolution was good under a 6 months antib
iotic treatment. Discussion Many factors can favorize the development
of a pubic tuberculosis and are similar for all forms of tuberculous o
steo-articular infection (trauma and contagion in our cases). Radiolog
ical features, characterized by a slow evolution, are note specific, D
iagnostic confirmation must be bacteriologic or pathologic, and if pos
sible far from the pubic foci. Any traumatic medical procedure has to
be avoided because of painful outcome and local risk. Evolution under
specific treatment, even of short course (6 months), is sufficient for
a good outcome. Conclusion One must think to pubic tuberculous osteo-
arthritis in any pubic pain even if It is post-traumatic especially, i
n endemic countries of tuberculosis.