Extraspinal bone tuberculosis: report of 19 cases
Rym Abid1, Najeh Boussetta1, Habiba Naija2,&, Salim Asli2, Mohamed Ben Moussa2, Riadh Battikh1, Salah Othmani1
1Internal Medicine Department of the Military Hospital of Tunis, Tunisia, 2Department of Microbiology, the Military Hospital of Tunis, Tunisia
Habiba Naija, Department of Microbiology, the Military Hospital of Tunis, Tunisia
extra-pulmonary tuberculosis (TB) is increasingly frequent. Extraspinal
bone infection is often misleading with clinical features depending on the
affected joint/Bone. The aim of the present work was to describe clinical, diagnostic,
therapeutic and evolutionary aspects of extra spinal bone TB according to
internal medicine department's experience.
retrospective study, conducted from January 2000 to January 2016 in the internal
medicine department of the Military Hospital of Tunis, Tunisia. We included
patients with peripheral osteoarticular tuberculosis. The diagnosis was either
confirmed on histological or bacteriological findings or retained based on
presumptive arguments. Nineteen patients met the inclusion criteria: 7 men and
The average age was 40 years (ranging between 15 to 77 years). Eight patients
had history of diabetes mellitus. Tuberculosis contagion was found in 7 cases
and personal history of tuberculosis in 3 cases. The majority of patients
(82%) were from rural areas. The average consultation delay was at 5 months.
of symptoms was progressive in almost all cases (96.3%). Signs of tuberculous
impregnation were noted in 65% of cases. Clinical signs were dominated by
pain: it was inflammatory or mixed in most cases (96%). Tuberculous localizations
were represented by sacroiliac joints in first place with (10 cases) then
in 3 cases and ankles and sacrum in 2 cases each. Iliac bone, clavicle, sternum
and shoulder were affected in one case each. Six patients had an associated
extra bone damage.
the TST (Tuberculin Skin Test) was performed in all patients and was found
to be positive only in 64% of cases. Imaging CT and/or MRI was pathological
in all cases. The diagnosis was confirmed in 11 patients by histological
examination and in 2 patients by bacteriology (isolation of BK on direct examination
1 case and culture in other case). All patients received TB treatment for
a median of 14 months. The outcome was always favorable.
extraspinal localization osteoarticular TB is an insidious disease. An early
diagnosis and care are crucially needed to prevent serious complications. Medical
treatment remains effective to date.
1st International Military Congress of Tropical Medicine and Sub-Saharan Diseases ()
Dates: 23 Oct 16 - 25 Oct 16
Contact person: Pr Salem Bouomrani (Salembouomrani@yahoo.fr)