Tuberculosis of the Foot

Öçgüder, Ali; Tosun, Özgür; Akkurt, Orcun; Oğuz, Temel; Colakoglu, Tugrul

doi:10.1097/01.rhu.0000250297.26149.8a

Cited by 6 publications

(3 citation statements)

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“…Given that difficulty in identifying the organism and the fact that the clinical symptoms are nonspecific with an insidious onset that can mimic other joint diseases like rheumatoid arthritis and osteoarthritis, the diagnosis of osteoarticular TB is often delayed. [ 13 ] In the previous study among Chinese patients, the mean time from symptom onset to diagnosis of bone and joint TB was 13.16 months (range from 0.5 to 96 months, median delay was 7 months). [ 14 ] In our study, the median duration from onset of articular symptoms to definite diagnosis was 17 months (IQR 8–63 months), suggesting a huge need for improvement.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of T-cell Interferon-γ Release Assays on Synovial Fluid for Articular Tuberculosis

Cheng

Bian

Zhang

et al. 2016

Chinese Medical Journal

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Background:Tuberculosis (TB) remains a major global public health challenge. Articular TB is an important form of extrapulmonary tuberculosis, and its diagnosis is difficult because of the low sensitivity of traditional methods. The aim of this study was to analyze the diagnostic value of T-SPOT.TB on synovial fluid for the diagnosis of articular TB.Methods:Patients with suspected articular TB were enrolled consecutively between August 2011 and December 2015. T-SPOT.TB was performed on both synovial fluid mononuclear cells (SFMCs) and peripheral blood mononuclear cells (PBMCs). The final diagnosis of articular TB was independent of the T-SPOT.TB result. The diagnostic sensitivity, specificity, predictive value, and likelihood ratio of T-SPOT.TB on SFMCs and PBMCs were analyzed.Results:Twenty patients with suspected articular TB were enrolled. Six were diagnosed with articular TB, and 14 patients were diagnosed with other diseases. Sensitivity and specificity were 83% and 86% for T-SPOT.TB on SFMCs, and 67% and 69% for T-SPOT.TB on PBMCs, respectively. The positive predictive value (PPV) and negative predictive value (NPV) of T-SPOT.TB on SFMCs were 71% and 92%, respectively. The PPV and NPV were 50% and 82% for T-SPOT.TB on PBMCs.Conclusion:Sensitivity, specificity, and NPV of T-SPOT.TB on SFMCs appeared higher than that on PBMCs, indicating that T-SPOT.TB on SFMCs might be a rapid and accurate diagnostic test for articular TB.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Value of T-cell Interferon-γ Release Assays on Synovial Fluid for Articular Tuberculosis

Cheng

Bian

Zhang

et al. 2016

Chinese Medical Journal

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“…The prevention, identification, treatment and eradication of Mycobacterium tuberculosis are significant health concerns, especially because of an increasing incidence and interaction between TB and HIV epidemics 14. TB infection in its various forms remains a major cause of high morbidity and mortality due to infectious diseases worldwide.…”

Section: Discussionmentioning

confidence: 99%

“…In our cases also, the hip and knee joints were among the most common joints affected, and this is comparable to what has been reported worldwide and in Saudi Arabia. The diagnosis of osteoarticular TB is often delayed, on an average by 16 to 19 months,19 and maybe up to 10 years,11 as a result of difficulty in identifying the organism and because the clinical symptoms are nonspecific and with insidious onset that can mimic common joint diseases like rheumatoid arthritis and osteoarthritis 14. In addition to the fact that some cases showed no systemic symptoms, in one case series 31.5% of patients with musculoskeletal tuberculosis had no systemic symptoms 11.…”

Section: Discussionmentioning

confidence: 99%

Tuberculous arthritis revisited as a forgotten cause of monoarticular arthritis

Al-Sayyad

Abumunaser

2011

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVES:Tuberculosis (TB) continues to be a major concern for health care workers. The number of reported cases of extrapulmonary tuberculosis, particularly osteoarticular tuberculosis, is increasing. This fact is attributed to different factors such as underestimating the disease and difficulty in diagnosis, which requires tissue sampling and can lead to a delay in the diagnosis, and can result in significant morbidity and mortality. The aim of this study was to highlight the difficulties and delay in diagnosis of articular tuberculosis, raising the need to create awareness about the importance of early diagnosis to avoid major complications of joint destruction.DESIGN AND SETTING:Retrospective review of patients presenting to a tertiary care center between 2003 and 2009.PATIENTS AND METHODS:We reviewed cases who presented with monoarticular joint pain and swelling that failed to respond to treatment elsewhere and were eventually diagnosed as having articular tuberculosis. We collected the demographic data, history, data on clinical examination and the relevant laboratory investigations, in addition to the data on radiological studies. All patients were treated medically with antituberculosis chemotherapy and surgically according to the severity of joint destruction.RESULTS:Thirteen patients had a mean age was 40 years (range, 17-70 years). The average delay in diagnosis was 2 years. Only 1 patient had pulmonary TB. The hip, knee and elbow were the most common joints involved. Bacteriology was positive in 69% of the cases; and histopathology, in 92%. Fifteen percent of the patients had arthrodesis. None showed recurrence after follow-up of 4 years.CONCLUSION:A high level of clinical suspicion is essential for early diagnosis and treatment of osteoarticular TB to reduce its significant morbidity.

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