TUBERCULOUS OSTEOMYELITIS

Tuberculous osteomyelitis which does not involve a joint is uncommon a nd may fail to be diagnosed by an orthopaedic surgeon, We treated 28 l esions of tuberculous osteomyelitis in 25 patients between 1988 and 19 95, The duration of symptoms was from two to 39 months, and most of ou r patients had been treated initially with non-steroidal anti-inflamma tory drugs which failed to provide relief. Bone pain which does not pr omptly respond to analgesic medication is often due to infection or ne oplasia. In the early stages, when plain radiographs are normal, MRI o r CT may help to localise lesions, On plain radiographs, more advanced lesions may mimic chronic pyogenic osteomyelitis, Brodie's abscess, t umours or granulomatous lesions, Biopsy is mandatory to confirm the di agnosis, and antituberculous drugs are the mainstay of treatment, When operative findings at biopsy have the features of skeletal tuberculos is curettage of the affected bone may promote earlier healing.