Tuberculosis of knee region in children: a series of eight cases

Kant, Kumar Shashi; Agarwal, Anil; Suri, Tarun; Gupta, Neeraj; Verma, Indreshwar; Shaharyar, Abbas

doi:10.1177/0049475513512633

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…Surgical curettage and diagnostic biopsy of the tissue around the growth plate in children may result in injury leading to shortening of the limb. 6 Moreover, the diagnostic dilemma regarding the possibility of tuberculosis may persist even after histopathological examination of tissue. ■…”

Section: Discussionmentioning

confidence: 99%

Lessons of the month 2: Tubercular osteomyelitis of the knee involving the growth plate in a young girl mimicking oligoarticular juvenile idiopathic arthritis

Sharma¹,

Kapil²

2022

Clinical Medicine

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Oligoarticular juvenile idiopathic arthritis (JIA) and tubercular arthritis in children can present in a similar way as monoarthritis. Patients with musculoskeletal tuberculosis may not have the classical constitutional symptoms. Moreover, microbiological evidence of infection may not be found in all patients. In such cases, features on imaging aid in the diagnosis. We present a case of an 8-year-old girl who had inflammation in the right knee. Investigations showed negative results for autoimmune markers. Synovial fluid examination did not reveal any evidence of tuberculosis. However, magnetic resonance imaging of the knee joint showed inflammation around the distal growth plate of the femur, away from the knee joint. The suspicion of tuberculosis was strengthened by the presence of left hilar lymphadenopathy on chest X-ray and positive result on tuberculin skin sensitivity test. The patient showed remarkable clinical and radiological recovery with antitubercular therapy. Peculiar features on imaging may help in differentiating infections from inflammatory arthritides, even in the absence of microbiological evidence of infection.

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Section: Discussionmentioning

confidence: 99%

Lessons of the month 2: Tubercular osteomyelitis of the knee involving the growth plate in a young girl mimicking oligoarticular juvenile idiopathic arthritis

Sharma¹,

Kapil²

2022

Clinical Medicine

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“…Synovial tuberculosis has a slow onset and mild symptoms [ 3 ]. It is more common in children and young adults with single joint.…”

Section: Backgroudmentioning

confidence: 99%

Synovial chondromatosis combine with synovial tuberculosis of knee joint: a case report

et al. 2022

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Backgroud Synovial chondromatosis is a rare synovial-derived metaplasia disease that comes from the formation of cartilage nodules within the synovial connective tissue of the joint. Knee tuberculosis is a disease caused mostly by the pulmonary tuberculosis and a few by tuberculosis of the digestive tract and lymphatic. tube. Case presentation Herein we report a 3-year-old child admitted by intermittent swelling of left knee joint with lameness for half a year, the patient received surgical treatment. The loose bodies filled in the joint cavity was taken out and the degenerative synovium was excised. Biopsy confirmed as synovial chondromatosis combined with synovial tuberculosis of knee joint. After 6 months follow-ups, knee swelling and claudication get totally recovered and the gait of patient recover back to normal. Conclusion Careful investigation of children with knee pain is recommended to avoid misdiagnosis, Synovial chondromatosis combine with tuberculosis should be considered a differential diagnosis in a child with knee pain.

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“…The epiphyseal plate offers little resistance to the spread of the tubercular focus. 11 Therefore epiphyseal lesions (proximal tibia and distal femur) are common in knee region. In epiphyseal variety (as compared to synovial variant), joint space is not reduced at the initial presentation unless the lesion is extensive.…”

Section: Kneementioning

confidence: 99%

Paediatric osteoarticular tuberculosis: A review

Agarwal

2020

Journal of Clinical Orthopaedics and Trauma

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Objective: Tuberculosis (TB) is endemic in Indian subcontinent. The paediatric osteoarticular (OA) TB is frequently confused with suppurative etiology as both can have similar clinical, radiological and laboratory presentation. It has become a health hazard due to its association with immunosuppression diseases such as HIV, chronic renal and liver diseases and use of immunosuppressive drugs. Furthermore, there is much dilemma regarding the drug choice and duration of anti tubercular treatment among practicing clinicians. This mini review briefs the reader to the classical regional and atypical tubercular clinical presentations, imaging and laboratory investigations and management for bone and joint TB. Methods: The article details both common and atypical clinical tubercular presentations, the approach to diagnosis, drug treatment and surgical indications in paediatric OA TB. Results: OA TB in the paediatric age group is uncommon. Diagnosis is often delayed because of diseases' nonspecific symptoms, non-characteristic imaging findings and lack of awareness of the condition. Multidrug antitubercular chemotherapy remains the anchor sheet of tubercular treatment in children. Surgery is needed in select cases to obtain tissue, to ensure better joint movement, prevent deformities and restore neurological function. Conclusions: TB can have varied presentation and therefore it is essential to keep tubercular infection in differential diagnosis while working up for any infective pathology. Conservative treatment produces good results in vast majority of cases. Surgery is reserved for select indications.

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Tuberculosis of knee region in children: a series of eight cases

Cited by 7 publications

References 10 publications

Lessons of the month 2: Tubercular osteomyelitis of the knee involving the growth plate in a young girl mimicking oligoarticular juvenile idiopathic arthritis

Lessons of the month 2: Tubercular osteomyelitis of the knee involving the growth plate in a young girl mimicking oligoarticular juvenile idiopathic arthritis

Synovial chondromatosis combine with synovial tuberculosis of knee joint: a case report

Paediatric osteoarticular tuberculosis: A review

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