TUBERCULOSIS ARTHRITIS

DEFINITION
Infection a synovial joint by
hematogenous spread from a distant
tuberculous lesion. Tuberculosis
arthritis caused by direct extension
of infection into the joint from an
area of tuberculous osteomyelitis in
the epiphysis.
 PATHOLOGY
The synovial membrane responds to tuberculous
infection by villous hyperthropy and an effusion
with resultant distension of the joint surfaces as a
tuberculous pannus which causes cartilage
necrosis. In addition, tuberculous granulation tissue
erodes subchondral bone to produce a local area of
tuberculous osteomyelitis with subsequent collapse
of bone. It borrows under articular cartilage causing
cartilage to sequestrate, the combination of
cartilage necrosis and destruction of the underlying
bone leads to irreparable joint damage. Healing of
tuberculous arthritis can lead to fibrous ankylosis.
PATHOLOGY
 DIAGNOSIS
A long history of pain or swelling
Involvement of only one joint
Marked synovial thickening
Severe muscle wasting
Enlarged and matted regional lymph
nodes
Periarticular osteoporosis on x-ray
A positive Mantoux test
 CLINICAL FEATURES
Painful limitation of joint motion,
protective muscle spasm, and
muscle arthropy are apparent.
The early sign is regional
osteoporosis like periarticular
osteoporosis at hip, in later osteolytic
in epiphysis become apparent.
Joint fluid have characteristic melon
seed bodies.
CLINICAL FEATURES
 TREATMENT
Rest
Antituberculous drugs
Surgical fusion / Arthrodesis