Tuberculous arthritis—the challenges and opportunities: observations from a tertiary center (2022)

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Indian Journal of Rheumatology

Volume 6, Issue 1, Supplement,

March 2011

, Pages 62-68

Abstract

Tuberculosis (TB) arthritis accounts for approximately 1–3% of all cases of tuberculosis and for approximately 10–11 % of extrapulmonary cases. The most common presentation is chronic monoarthritis. The Poncet's disease is a reactive symmetric form of polyarthritis that affects persons with visceral or disseminated TB. TB arthritis primarily involves the large weight-bearing joints, in particular the hips, knees, and ankles, and occasionally involves smaller nonweight-bearing joints. The diagnosis of TB arthritis is often delayed due to lack of awareness, insidious onset, lack of characteristic early radiographie findings and often lack of constitutional or pulmonary involvement. A high index of suspicion is necessary, especially in the context of persistent monoarthritis and synovial biopsy and prompt anti-tubercular therapy with adequate doses and duration prevents joint damage and preserves joint function. Surgical procedures should be restricted to joints with severe cartilage destruction, large abscesses, joint deformity or atypical mycobacteria.

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References (25)

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    TB tenosynovitis of the hand. A study of 33 cases of chronic tenosynovitis of the hand

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  • GF Walker

    Failure of early recognition of skeletal TB

    Br Med J

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    Copyright © 2011 Indian Rheumatology Association. Published by Elsevier, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.

    FAQs

    What causes tuberculosis arthritis? ›

    Tuberculous arthritis is caused by the bacteria, Mycobacterium tuberculosis. A very small number of people who have TB will develop this form of arthritis. The joints most often involved are the: Ankles.

    What is the treatment for TB arthritis? ›

    Tuberculous arthritis is usually monoarticular and diagnosis is often delayed. The treatment of osteoarticular TB is primarily medical and includes multi-antituberculosis drugs for a period of 9 to 12 months. In the early stages approximately 90% to 95% of patients achieve healing with near-normal function.

    What joint is most commonly affected by tuberculosis? ›

    In adults, the lower thoracic and upper lumbar vertebrae are most commonly involved, whereas in children the upper thoracic spine is the most frequent site. The hip or knee is involved in 15–20% of cases, and shoulders, elbows, ankles, wrists, and other bones or joints also make up 15–20%.

    Can tuberculosis cause reactive arthritis? ›

    Reactive arthritis in tuberculosis (TB) is known as Poncet's disease, a rare aseptic form of arthritis observed in patients with active TB. We report a case of Poncet's disease in a 20-year old man whose reactive arthritis overshadowed other clinical symptoms of TB resulting in delayed diagnosis and treatment.

    How is TB arthritis diagnosed? ›

    The gold standard for diagnosis of tubercular arthritis is synovial biopsy, with positive results in 80% of cases [86,87]. It shows caseating granulomas, lymphocytes, and giant cells with caseation, which is very characteristic of tubercular arthritis.

    How can we prevent tuberculosis? ›

    1. Take all of your medicines as they're prescribed, until your doctor takes you off them.
    2. Keep all your doctor appointments.
    3. Always cover your mouth with a tissue when you cough or sneeze. ...
    4. Wash your hands after coughing or sneezing.
    5. Don't visit other people and don't invite them to visit you.
    Dec 16, 2020

    Is tuberculous arthritis contagious? ›

    Latent TB , also called inactive TB or TB infection, isn't contagious. Latent TB can turn into active TB , so treatment is important. Active TB . Also called TB disease, this condition makes you sick and, in most cases, can spread to others.

    Can you get TB in your bones? ›

    Tuberculosis is a severe infectious disease that usually affects your lungs. When it spreads to your bones, it's known as skeletal tuberculosis.

    How does TB affect the body? ›

    The general symptoms of TB disease include feelings of sickness or weakness, weight loss, fever, and night sweats. The symptoms of TB disease of the lungs also include coughing, chest pain, and the coughing up of blood. Symptoms of TB disease in other parts of the body depend on the area affected.

    What are the 3 types of tuberculosis? ›

    Tuberculosis is a bacterial infection that usually infects the lungs. It may also affect the kidneys, spine, and brain. Being infected with the TB bacterium is not the same as having active tuberculosis disease. There are 3 stages of TB—exposure, latent, and active disease.

    Can TB of the bones be cured? ›

    Bone TB Symptoms

    It is a serious condition since it destroys the thoracic and leads to bone deformity. It is extremely important to detect bone tb symptoms as soon as possible. Bone tb is a curable condition if detected soon.

    How does tuberculosis affect the brain? ›

    Untreated, this disorder can lead to seizures, hydrocephalus (accumulation of fluid in the brain cavity), deafness, mental retardation, paralysis of one side of the body (hemiparesis) and other neurological abnormalities.

    Which TB drugs cause joint pain? ›

    Among antitubercular drug, pyrazinamide is know to cause joint pain in few patient.

    Does TB cause bone pain? ›

    Bone TB severely affects the joints of the hips and knees. It is also a bonus disease for AIDS patients. A typical tuberculous like osteoarticular manifestations are common. It causes pain in the extraspinal skeleton, trochanteric area, or a prosthetic joint.

    Does TB affect joints? ›

    Bone tuberculosis is simply a form of TB that affects the spine, the long bones, and the joints. In the United States, only about 3 percent of all TB cases affect the musculoskeletal system. Of those cases, the spine is most commonly affected.

    What is the tertiary prevention of tuberculosis? ›

    Tertiary Prevention11

    The treatment of people who have already developed a disease is often described as tertiary prevention. The final strategy used for preventing and controlling TB in the United States is identifying and treating patients with active TB.

    What are the risk factors and causes of TB? ›

    Persons with Medical Conditions that Weaken the Immune System
    • HIV infection (the virus that causes AIDS)
    • Substance abuse.
    • Silicosis.
    • Diabetes mellitus.
    • Severe kidney disease.
    • Low body weight.
    • Organ transplants.
    • Head and neck cancer.

    Where does tuberculosis come from? ›

    tuberculosis was originated in East Africa about 3 million years ago. A growing pool of evidence suggests that the current strains of M. tuberculosis is originated from a common ancestor around 20,000 – 15,000 years ago.

    Who is most at risk for tuberculosis? ›

    Groups at High Risk for Developing TB Disease
    • Persons who have had a gastrectomy or jejunoileal bypass.
    • Persons with low body weight (<90% of ideal body weight)
    • People who use substances (such as injection drug use)
    • Populations defined locally as having an increased incidence of disease due to M.

    Can you get TB if vaccinated? ›

    I live with somebody who has a weakened immune system. If I have the vaccine, is there a risk that I could infect them? The BCG vaccine does not give you TB. If you live with someone who has a weakened immune system, you cannot give them TB from having the vaccine.

    What happens if you test positive for TB? ›

    A “positive” TB blood test result means you probably have TB germs in your body. Most people with a positive TB blood test have latent TB infection. To be sure, your doctor will examine you and do a chest x-ray. You may need other tests to see if you have latent TB infection or active TB disease.

    How does tuberculosis cause death? ›

    “Eventually, liquid replaces the lungs, the suffering patients cannot get enough oxygen, and respiratory failure occurs, they can no longer breathe and they drown. It's painful, it's drawn out. It's an awful way to die.

    What is the other name for tuberculosis? ›

    Tuberculosis (TB) was called “phthisis” in ancient Greece, “tabes” in ancient Rome, and “schachepheth” in ancient Hebrew. In the 1700s, TB was called “the white plague” due to the paleness of the patients. TB was commonly called “consumption” in the 1800s even after Schonlein named it tuberculosis.

    What type of disease is tuberculosis? ›

    Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. Not everyone infected with TB bacteria becomes sick.

    What food is good for bone TB? ›

    Foods Rich in Vitamin A, C and E

    Fruits and vegetables like orange, mango, sweet pumpkin and carrots, guava, amla, tomato, nuts and seeds are an excellent source of Vitamin A, C and E. These foods must be included in the daily diet regime of a TB patient.

    How long does TB treatment side effects last? ›

    It may be several weeks before you start to feel better. The exact length of time will depend on your overall health and the severity of your TB. After taking antibiotics for 2 weeks, most people are no longer infectious and feel better.

    Can MRI detect bone TB? ›

    MRI offers excellent visualization of the bone and soft tissue components of spinal tuberculosis and helps to identify disease at distant asymptomatic sites. CT is useful in assessing bone destruction, but is less accurate in defining the epidural extension of the disease and therefore its effect on neural structures.

    Does TB cause memory loss? ›

    There are a number of causes of memory loss, including medications; heavy drinking; stress; depression; head injury; infections such as HIV, tuberculosis, syphilis and herpes; thyroid problems; lack of quality sleep; and low levels of vitamins B1 and B12.

    How does tuberculosis affect the spine? ›

    In spinal tuberculosis, characteristically, there is destruction of the intervertebral disk space and the adjacent vertebral bodies, collapse of the spinal elements, and anterior wedging leading to the characteristic angulation and gibbus (palpable deformity because of involvement of multiple vertebrae) formation.

    Can tuberculosis cause mental illness? ›

    An association has been described between TB and CMDs, where approximately 39%–70% of pulmonary TB cases have been found to have anxiety or depression [8]–[10].

    What are the side effects of tuberculosis treatment? ›

    Side Effects of Treatment
    • Fever for 3 or more days.
    • Pain in the lower abdomen.
    • Itchiness or a rash.
    • Nausea, vomiting, or no appetite.
    • Yellowish skin or eyes.
    • Dark or brown urine.
    • Tingling, burning, or numbness of the hands and feet.
    • Fatigue.
    Sep 19, 2021

    What does TB pain feel like? ›

    If TB affects your joints, you may develop pain that feels like arthritis. If TB affects your bladder, it may hurt to go to the bathroom and there may be blood in your urine. TB of the spine can cause back pain and leg paralysis. TB of the brain can cause headaches and nausea.

    Is tuberculosis arthritis contagious? ›

    ‌Tuberculosis is a contagious disease, which means it can spread from one person to another. It's more common in developing countries, but about 7,163 cases were reported in the U.S. in 2020. Tuberculosis can be deadly.

    Can Rheumatoid arthritis cause tuberculosis? ›

    As shown in a Spanish study, rheumatoid arthritis (RA) patient has 4-fold increased risk of TB disease as compared to general population [3]. It is well established that Th1 mediated cytokines play crucial roles in the protective immunity against TB disease [4–6].

    Can TB cause inflammatory arthritis? ›

    Introduction. Mycobacterium tuberculosis causes infection in approximately one-third of the world's population. Arthritis due to Mycobacteriurn tuberculosis usually presents as a chronic, slowly progressive, monoarticular infection that predominantly involves the weight-bearing joints and the spine.

    Does tuberculosis affect joints? ›

    One form of EPTB is bone and joint tuberculosis. This makes up about 10 percent of all EPTB cases in the United States. Bone tuberculosis is simply a form of TB that affects the spine, the long bones, and the joints. In the United States, only about 3 percent of all TB cases affect the musculoskeletal system.

    Who is most at risk for tuberculosis? ›

    Groups at High Risk for Developing TB Disease
    • Persons who have had a gastrectomy or jejunoileal bypass.
    • Persons with low body weight (<90% of ideal body weight)
    • People who use substances (such as injection drug use)
    • Populations defined locally as having an increased incidence of disease due to M.

    How does tuberculosis affect the body? ›

    The general symptoms of TB disease include feelings of sickness or weakness, weight loss, fever, and night sweats. The symptoms of TB disease of the lungs also include coughing, chest pain, and the coughing up of blood. Symptoms of TB disease in other parts of the body depend on the area affected.

    Can bone tuberculosis be cured? ›

    It is a serious condition since it destroys the thoracic and leads to bone deformity. It is extremely important to detect bone tb symptoms as soon as possible. Bone tb is a curable condition if detected soon.

    Can drugs cause tuberculosis? ›

    Drug use has been associated with higher prevalence of latent TB infection (LTBI)[11, 12], and incidence of TB disease[13, 14]. A number of studies[15–36] have characterized the LTBI prevalence (10%–59%) among various cohorts of drug users (Table 1).

    What is the fastest way to cure TB? ›

    You'll be prescribed at least a 6-month course of a combination of antibiotics if you're diagnosed with active pulmonary TB, where your lungs are affected and you have symptoms. The usual treatment is: 2 antibiotics (isoniazid and rifampicin) for 6 months.

    Which drugs can reactivate TB? ›

    TNF blockers and drug synergy

    Drugs like methotrexate may synergize in immunosuppression to interfere with granuloma integrity. Against this argument is the propensity of these agents to reactivate tuberculosis as opposed to other infections [16].

    Which TB drugs cause joint pain? ›

    Among antitubercular drug, pyrazinamide is know to cause joint pain in few patient.

    Does TB cause bone pain? ›

    Bone TB severely affects the joints of the hips and knees. It is also a bonus disease for AIDS patients. A typical tuberculous like osteoarticular manifestations are common. It causes pain in the extraspinal skeleton, trochanteric area, or a prosthetic joint.

    Where does tuberculosis come from? ›

    tuberculosis was originated in East Africa about 3 million years ago. A growing pool of evidence suggests that the current strains of M. tuberculosis is originated from a common ancestor around 20,000 – 15,000 years ago.

    What are the 3 stages of tuberculosis? ›

    There are 3 stages of TB—exposure, latent, and active disease. A TB skin test or a TB blood test can diagnose the disease. Treatment exactly as recommended is necessary to cure the disease and prevent its spread to other people.

    How does tuberculosis affect the brain? ›

    Untreated, this disorder can lead to seizures, hydrocephalus (accumulation of fluid in the brain cavity), deafness, mental retardation, paralysis of one side of the body (hemiparesis) and other neurological abnormalities.

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