TOTBİD Dergisi

TOTBİD Dergisi

2011, Cilt 10, Sayı, 3     (Sayfalar: 258-261)

Tuberculosis of skeletal system

Oktay Adanır 1, Ender Alagöz 1, Muhammed Zeki Gültekin 1

1 Bağcılar Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, İstanbul

Görüntüleme: 596
İndirme : 1327

According to the current data one-third of world`s population is infected with tuberculosis; and approximately 30 million of these are receiving tuberculosis treatment. One to three percent of these people have involvement of the skeletal system. Vertebral tuberculosis is the most common form of skeletal tuberculosis. Other major areas of predilection are, in order of frequency, hip, knee, foot, elbow, hand, shoulder and bursal sheaths. In 90% of the cases tuberculosis is monoarticular. The most commonly isolated patogen microorganisms are Mycobacterium tuberculosis and Mycobacterium bovis. Tuberculosis is generally transmitted through inhalation and spread to other organs hematogenously. In children tuberculosis mainly affects metaphyseal part of the load bearing bones, whereas in adults it mainly affects the epiphyseal part of the bones. Definitive diagnosis is established by demonstration of tuberculosis bacilli in body fluids. Tuberculosis can present itself as a lytic lesion on X-rays and can mimic tumoral pathologies. The sensitivity of scintigraphy in bone tuberculosis is 88-96% but it has a low specificity. Magnetic resonance imaging studies are useful mainly in the diagnosis of soft tissue abscesses. Ninety percent of the cases of skeletal tuberculosis are treated with conservative methods (anti-tuberculosis drug treatment, immobilization etc), but in 10% of the cases surgery can be the treatment of choice (drainage, debridement, osteotomy, arthrodesis etc.). The duration of anti-tuberculosis drug treatment is generally 6-12 months. If surgery will be performed; it is required to start anti-tuberculosis drug treatment 1-4 weeks before surgery.

Anahtar Kelimeler : Mycobacterium tuberculosis; osteoarticular. tuberculosis