Tuberculosis (musculoskeletal manifestations)

Last revised by Daniel J Bell on 22 Jul 2017

Musculoskeletal tuberculosis is always secondary to a primary lesion in the lung.

Epidemiology

The prevalence of the disease is around 30 million globally and 1-3% of the 30 million have involvement of their bones and/or joints. Mycobacterium tuberculosis is responsible for almost all of the cases of osteoarticular tuberculosis; although atypical mycobacteria have been reported in lesions of the synovial sheath.

The predisposing factors are protein-energy malnutrition, environmental conditions and living standards such as poor sanitation, overcrowded housing and slum dwelling. Trauma as a causative factor is debatable, but has been reported. Acquired immunodeficiency syndrome and other causes of immunocompromised status and repeated pregnancies and lactation in women are also a factor.

Pathology

Osteoarticular tuberculosis can occur in the spine, hip, knee, foot, elbow, wrist, hand, shoulder and as diaphysial foci. It has not been reported to affect the mandible or the temporomandibular joint. The major method of spread is hematogenous. The most common method of spread to the vertebral body is through the Batson prevertebral venous plexus.

Osteoarticular tuberculosis is reported in various sites including:

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Case 1: osteitis tuberculosa multiplex cystoides
    Drag here to reorder.
  • Case 2
    Drag here to reorder.
  • Case 3: affecting knee
    Drag here to reorder.