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At least 19 recordsLinked to original sources
PubMed1987

Computed tomography of musculoskeletal tuberculosis.

The usefulness of computed tomography (CT) in the evaluation of musculoskeletal tuberculosis was assessed in 10 patients. In six tuberculosis affected the dorsal spine, in two the chest wall, in one the sacrum and sacroiliac joint, and in one the greater trochanter. At all sites the CT findings were qualitatively similar: specifically, destructive osseous changes associated with adjacent soft-tissue masses showing a characteristic rim enhancement. Soft-tissue calcification was present in 8 of the 10. In all patients, CT demonstrated more extensive involvement than could be seen on plain radiographs. In five patients, CT first suggested the diagnosis. We conclude that CT is helpful in the evaluation of patients with musculoskeletal tuberculosis.

Adult↗
PubMed2026

Association of Vitamin D Receptor Gene Polymorphism (FokI) with Susceptibility to Musculoskeletal Tuberculosis: A Case-Control Study from Central India.

AIM AND BACKGROUND: Musculoskeletal tuberculosis (MSKTB) constitutes a significant proportion of extra-pulmonary tuberculosis (TB), particularly in developing countries like India. While host genetic factors are known to influence susceptibility to TB, the Vitamin D receptor (VDR) gene, particularly the FokI polymorphism, has been implicated in immune regulation and susceptibility to pulmonary and extra-pulmonary TB, data on genetic predisposition to MSKTB remain limited. The present study aimed to investigate the role of the VDR FokI gene polymorphism in determining susceptibility to MSKTB. MATERIALS AND METHODS: This study included 110 patients with confirmed MSKTB and 112 controls without TB, recruited from a tertiary care institution over a 3-year period. Clinical and demographic data were obtained. Genomic DNA was extracted from peripheral venous blood samples, and VDR FokI polymorphism was detected using polymerase chain reaction-based restriction fragment length polymorphism analysis. Genotype and allele frequencies were compared using a Chi-square test, and odds ratios (OR) with 95% confidence intervals (CI) were calculated. RESULTS: The ff genotype was significantly more frequent in cases (17.3%) compared to controls (9.8%) and was associated with increased risk of MSKTB (OR = 2.30, 95% CI: 1.03-5.15, P = 0.04). The polymorphic f allele frequency was also significantly higher in cases than controls (38.2% vs. 28.1%; OR = 1.58, 95% CI: 1.05-2.37, P = 0.023). However, the dominant and recessive genetic models showed a non-significant association. Demographically, MSKTB was more common among females, individuals from rural backgrounds, those of lower socioeconomic status, and those with low body mass index. CONCLUSION: The VDR FokI polymorphism, particularly the ff genotype and f allele, is associated with increased susceptibility to MSKTB. These findings highlight the potential role of genetic factors in MSKTB and may aid in identifying at-risk populations.

FokI polymorphism↗
PubMed1991

Tuberculous tenosynovitis of the wrist. Two case reports.

Tuberculosis was first described in 1756 by Acrel in a case report. Subsequent reports of musculoskeletal tuberculosis documented the uncommon occurrence of hand and wrist involvement. The two cases presented here demonstrate the difficulty in eradicating the organism even with modern regimens of chemotherapy. Intraoperative Gram's stain and frozen sections were useful to rule out other etiologies. Firm diagnosis must be established by tissue culture. The first case appeared cured after thorough initial debridement and had no recurrence for 36 years. While recurrences are common in patients treated with debridement alone, most appear within one year after the index procedure. The amount of time that elapsed in this case is unusual and serves as a sobering reminder that tuberculosis may recur at a time distant from the initial procedure. The second patient had tuberculosis diagnosed elsewhere and was treated twice with antituberculous chemotherapy. Although the first course of therapy for six months may have been inadequate, the second course with multiple drugs for 18 months would certainly be considered adequate; yet he had a recurrence in his wrist eight months after completing treatment. These two cases illustrate the fastidious nature of the Mycobacterium tuberculosis organism and the need for a combined treatment protocol of meticulous surgical debridement and combined chemotherapy.

Aged↗
PubMed1976

Carpal tunnel syndrome as the initial manifestation of tuberculosis.

Two patients presenting with carpal tunnel syndrome as the initial manifestations of tuberculosis were seen during a recent four month period at a larg city-county hospital. Although the clinical picture of the carpal tunnel syndrome was typical, a definite diagnosis could not be made until the time of surgery because of the many other causes of the carpal tunnel syndrome. A review of the experience with musculoskeletal tuberculosis and carpal tunnel syndrome at our hospital indicates that although this combination is not common, it is one of the treatable causes of the carpal tunnel syndrome. A review of the literature substantiates this impression.

Aged↗
PubMed1986

Perthes' disease. The family tree.

The discovery and use of roentgenograms by Wilhelm Röntgen in 1895 was one of the most important turning points in the history of orthopedics. Within only a few years, immense advances were made in the recognition and definition of bone and joint disorders that, until then, had been thought to be different or unusual forms of musculoskeletal tuberculosis. Perthes' disease has become one of the Lieblingsthema of orthopedics. The study of the history of Perthes' disease is fascinating: the sources of many "original" thoughts can be traced back across the world, through the years. This review begins with the 19th century, traces the emergence of the definition of Perthes' disease and some related conditions, and follows the story of the disease in the first decade of its history as a separate entity.

Femur Head Necrosis↗
PubMed1987

Granulomatous musculoskeletal disease: sarcoidosis versus tuberculosis.

A patient with systemic sarcoidosis insidiously developed tuberculous arthritis. The concurrence of these diagnoses in any individual patient is rare. Musculoskeletal features of sarcoidosis and tuberculosis are reviewed, and the importance of obtaining appropriate cultures to differentiate these granulomatous disorders is illustrated.

Adult↗
PubMed1988

Bone and joint tuberculosis: a review of 652 cases.

The results of a computerized study of 652 cases of bone and joint tuberculosis were presented. The cases were studied according to a program of 76 variables. From the various results of such a study, the following data were found. A high rate of tuberculous osteomyelitis (19%) and of tuberculosis of the upper limb joints (14%) were found. The reliability of a new x-ray classification based on the degree of destruction of the joint should be emphasized along with the reliability of biological examinations. All patients were treated according to the same principles; chemotherapy against tuberculosis, and surgical measures against musculoskeletal destruction. The results were excellent for tuberculosis. A favorable response to chemotherapy was found in 98% with only 3% of the cases relapsing. Anatomical results were surprisingly good and excellent in 56% of the cases, in spite of the low rate of surgery performed. Fair anatomical results often gave good functional results if no deformity persisted.

Adolescent↗
PubMed1988

[Various aspects of tuberculosis of the hand: apropos of a series of 45 cases].

Localisation of tuberculosis in the hand is a rare entity. We report here on 45 cases representing 7% of 650 cases of tuberculosis of the musculoskeletal system treated in our clinic during the past 16 years. Localisation in a joint or tendon sheath is classic but some others such as osteitis (8 cases) or soft tissue lesions (3 cases) have been seen, so the diagnosis must be proved bacteriologically by demonstrating the presence of the tubercle bacillus or, more often, histologically. A prolonged clinical course before the patient seeks medical advice is common and the clinical manifestations are numerous. Some patients were treated with a classical one year regimen. More recent cases have been treated with a short six month regiment. A comparison of the effectiveness of the two regimes is made.

Adolescent↗
PubMed1992

Leukemia, lymphoma, and multiple myeloma following selected medical conditions.

The role of selected prior medical conditions in the etiology of hematopoietic malignancies was examined in a case-control study of members of two regional branches of the Kaiser Permanente Medical Care Program (USA). Past history of chronic infectious, autoimmune, allergic, and musculoskeletal disorders was abstracted from medical records for leukemia (n = 299), non-Hodgkin's lymphoma (NHL, n = 100), and multiple myeloma (n = 175) cases and matched controls (n = 787). Little difference was found between cases and controls for most of the chronic conditions evaluated, including sinusitis, carbuncles, urinary tract infections, pelvic infections, herpes zoster, asthma, rheumatoid arthritis, psoriasis, bursitis, and gout. Only three statistically significant elevated risks were found, i.e., with combined disc disease myeloma among patients with prior eczema and disk and other musculoskeletal conditions, and NHL following tuberculosis. Only two of these associations showed consistent patterns by sex and geographic region (myeloma with eczema and with musculoskeletal conditions). While prior history of eczema and musculoskeletal conditions may slightly increase risk of myeloma, this study provided little if any support for an association of chronic infectious, autoimmune, allergic, and musculoskeletal conditions with subsequent occurrence of the leukemias or NHL. Additionally, these data did not support a role for chronic antigenic stimulation, as defined in previous epidemiologic studies, in the etiology of hematopoietic malignancies.

Aged↗
PubMed1987

Mycobacterial disease in the musculoskeletal system.

Over a six-year period, 12 patients were admitted to a Melbourne teaching hospital with mycobacterial infections of the musculoskeletal system. Four of the infections involved soft tissue and these included three atypical mycobacterial infections. The average age at diagnosis was 60 years. Five patients were born outside Australia. The predisposing factors included a past or family history of tuberculosis, pre-existing arthritis, alcoholism, earlier trauma, and membership of certain occupations. The average delay in diagnosis was four months. Treatment involved a combination of appropriate medication and surgical procedures that ranged from diagnostic aspiration to amputation. Mycobacterial infection of the musculoskeletal system, although uncommon in Australia, remains an important problem that requires continued awareness for early diagnosis.

Adult↗
PubMed1991

Rheumatic manifestations of neoplasia.

Neoplasia in an important cause of rheumatic disease. The mechanisms are either direct infiltration of the bone and joint, or indirect infiltration with manifestations distant from the site of neoplastic involvement. Many of the reports reviewed in this article center on direct associations. In particular, there is a report on polymyositis and dermatomyositis and the link with neoplasia. Cases of reflex sympathetic dystrophy are also described in association with neoplasia. There is further discussion on the link of hairy cell leukemia and vasculitis. Other case reports highlight the multiple associations of musculoskeletal disease and neoplasia. These reports include patients with subcutaneous sarcoidosis, ankylosing spondylitis, polychondritis, and systemic sclerosis. Articular manifestations of benign pleural fibromas are described. The existence of these reports, however, does not constitute proof of a causal relationship and the possibility of chance occurrences of two conditions must be considered. Finally, various therapies for cancer are associated with rheumatologic manifestations. Intravesical bacillus Calmette-Guérin has been found to cause an inflammatory polyarthritis. This form of arthritis is similar to experimentally induced adjuvant arthritis in rats that follows immunization with Freund's adjuvant containing Mycobacterium tuberculosis.

BCG Vaccine↗
PubMed1986

Bone scintigraphy in tuberculous sacroiliitis.

Radionuclide bone imaging is becoming increasingly important in the evaluation of musculoskeletal pain of uncertain cause. A case in which Tc-99m MDP bone imaging was employed to investigate complaints of low back pain is presented. Scan abnormalities directed clinicians towards appropriate further workup and diagnosis of unilateral tuberculous sacroiliitis.

Adult↗
PubMed1980

Computed tomography of musculoskeletal disorders of the truncus.

Computed Tomography (CT) is a new diagnostic tool in the evaluation of the musculoskeletal system. In the present study 29 patients with benign or malignant lesions in the body have been examined by this method. The purpose has been to evaluate the value of CT scanning in disorders of the musculoskeletal tissues. CT is an effective modality for demonstrating the three-dimensional extent of lesions, but in about one-third of the cases the examinations were not able to distinguish between benign and malignant lesions.

Abscess↗
PubMedDate not supplied

[Spondylitis in the aged].

The spondylitis of the old patient is often late recognizable because of superposition with senile degeneration. The treatment is conform to the classical rules of musculoskeletal infections, after securing the diagnosis. The high risk of immobilisation in the age can be reduced by the operative therapy, but on the other hand must be an acceptance of the operative risk. Last named is very small, if the team is good acquainted with his work, accordingly short length of operation-time and without big histological lesions.

Aged↗