Tuberculosis of the Hip

Tuberculosis of greater trochanter presenting as avulsion fracture of greater trochanter-A case report

“…Incidence of tuberculosis of greater trochanter have been reported 1.8%-2.3% of musculoskeletal tuberculosis [1,4,5] . Teale in 1870 first describe tuberculosis of greater trochanter.…”

“…Tuberculosis of greater trochanter is well establish but is comparatively rare site of involvement. Greater trochanter tuberculosis is about 2% of musculoskeletal tuberculosis [1] . The clinical presentation of tuberculosis of greater trochanter is often vague [2] .…”

Tuberculosis of the Musculoskeletal System

“…There is also a role for prosthetic reconstruction. 4,11,31,32 Current evidence suggests that there should be a significant disease free interval (ideally 10 years) in between the completion of treatment and prosthetic implantation. Prophylactic chemotherapy for several weeks to months may allow earlier implantation, and chemotherapy can often salvage a prosthetic joint when reactivation of infection has been observed.…”

“…While some authors feel that chemotherapy alone is sufficient, 7 others recommend surgery when significant synovitis is present, but before joint destruction. 4,37,71,83 In the later stages, traction or osteotomy may help realign the extremity, and casting can secure this position until the joint fuses. An alternative for those desiring motion at the expense of stability is excisional arthroplasty, when restoration of motion may take precedence over painless stability to allow cross legged sitting and squatting.…”

The comparison of pyrosequencing molecular Gram stain, culture, and conventional Gram stain for diagnosing orthopaedic infections

“…7,8 Although tuberculosis is not a cause of orthopedic device infection, implantable material may be used in sites of skeletal tuberculosis, particularly the hip and spine. 9,10 Clinical microbiologists are more and more commonly using the polymerase chain reaction (PCR) and other nucleic acid amplification assays for the detection and identification of microbial pathogens and to determine the most important mechanisms of antimicrobial resistance. Realtime or homogeneous PCR is a relatively new modification of the PCR, 11,12 wherein amplification and detection occur in the same reaction vessel secondary to the use of fluorescent detector molecules.…”