Insidious destruction of the hip by Mycobacterium tuberculosis and why early diagnosis is critical

Tuberculosis has re-emerged as an important problem in the United States. M ore than 10 million people presently are infected with Mycobacterium tuberc ulosis in the United States alone. The symptoms at first presentation of th e disease have because more diverse. With extrapulmonary manifestations, su ch as musculoskeletal infections as the sole presenting sign, it often can br difficult to determine the correct diagnosis early in the course of the disease. The presenting symptoms, physical signs, and radiographic findings of intra-articular tuberculosis can mimic those of other intra-articular d iseases, such as rheumatoid arthritis, osteoarthritis, and avascular necros is. in view of the nonspecific findings early in course of the disease, tub ercular infection should be considered in the differential diagnosis when t here is insidious articular destruction. Failure to consider tuberculosis c an lead to devastating outcomes otherwise preventable with today's chemothe rapies.