Current concepts in the diagnosis and management of tuberculosis of the elbow joint

Abstract

Elbow is an uncommon joint to be affected by Mycobacterium tuberculosis infection. It is involved in approximately 1e5% of all cases with musculoskeletal tuberculosis (TB). Early diagnosis of TB of the elbow joint can be easily missed due to an indolent natural history, delay in presentation, and varied clinical features. Delay in diagnosis can lead to irreversible osteoarticular destruction and loss of joint function. Careful clinical assessment, adequate imaging, microbiological, and/or histopathological confirmation of Mycobacterium tuberculosis infection is essential for early diagnosis of TB of the elbow joint. Judicious and early administration of anti-tubercular therapy can lead to preservation of the joint and a satisfactory functional outcome. Surgical intervention may be needed in later stages of the disease to achieve control of the infection, correction of deformity, instability, and restoration of function.

Tuberculosis of the Elbow Joint in an Indian Boy: A Rare Entity With a Diagnostic Challenge

“…Tuberculosis of the elbow is reported scarcely in the literature, and only a few cases with similar clinical presentations have been reported in pediatric patients [6].…”

“…Tuberculosis of the upper limb is seldom reported and is an infrequently encountered condition in outpatient departments [ 8 ]. Rarely are reports of elbow joint involvement found in the literature [ 6 ]. Elbow tuberculosis typically occurs as a result of hematogenous dissemination from a primary infection elsewhere in the body, primarily affecting children, which could be attributed to increased vascularity of the bones [ 6 , 9 ].…”

“…Rarely are reports of elbow joint involvement found in the literature [ 6 ]. Elbow tuberculosis typically occurs as a result of hematogenous dissemination from a primary infection elsewhere in the body, primarily affecting children, which could be attributed to increased vascularity of the bones [ 6 , 9 ]. Moreover, the revival of a dormant focus following the emergence of a latent tuberculosis infection could also result in the disease [ 9 ].…”

“…About 30%-40% of extrapulmonary tuberculosis cases, and 1%-3% of all tuberculosis cases are attributed to musculoskeletal tuberculosis. The hip, knee, and other joints are the most frequently afflicted, followed by the spine [ 6 ]. Elbow joint tuberculosis is an uncommon condition, with an estimated 1%-5% of all musculoskeletal tuberculosis cases affecting the elbow joint [ 7 ].…”

A big round hole in the elbow

“…However, bone erosions are part of disease progression, but strikingly circular enlargement of the coronoid fossa is not well described. [3] Non-specific radiological features also do not mention the occurrence of a symmetrically enlarged coronoid or olecranon fossa. However, common features are described as a synovial thickening, intraosseous abscesses, and cavities.…”