Tuberculous arthritis
Definition
Tuberculous arthritis is an infection of the joints due to tuberculosis.
See also: Spondylitis
Alternative Names
Granulomatous arthritisCauses
Approximately 2% of people who have tuberculosis will develop this form of arthritis. The joints most often involved are the:
- Ankles
- Hips
- Knees
- Spine
- Wrists
Most cases involve just one joint.
Tuberculosis involving the spine is often referred to as Pott's disease. The fictional Hunchback of Notre Dame had a humpback that is thought to have been caused by tuberculosis.
Symptoms
- Decreased movement in the joints
- Excessive sweating, especially at night
- Joint swelling with warm, tender joints
- Low-grade fever
- Muscle atrophy
- Muscle spasms
- Numbness, tingling, or weakness below the infection (if the spine is involved)
- Weight loss or loss of appetite
Note: The condition usually starts slowly and may involve only one joint.
Exams and Tests
A physical examination shows swelling and irritation (inflammation) of the joint.
Tests:
- Aspiration of fluid in the joint
- Biopsy of the joint to detect the bacteria that causes tuberculosis
- Chest x-ray
- Joint x-rays
- Tuberculin skin test (also called PPD)
Treatment
You will take antibiotics to destroy the bacteria that are causing the tuberculosis infection. These medications are often given for several months (6 - 18 months).
Taking painkillers and applying heat or cold to the joints may relieve pain. Surgery may be needed, especially to drain spinal abscesses or to stabilize the spine. Surgery is rarely needed for infections at other sites.
Outlook (Prognosis)
This form of arthritis can be very destructive to the tissues. Controlling the infection should prevent more joints from becoming involved. However, joint destruction may take place before the infection is controlled.
Possible Complications
- Collapse of the vertebrae, resulting in kyphosis
- Joint destruction
- Spinal cord compression
When to Contact a Medical Professional
Call your health care provider if you have symptoms of this disorder, or of tuberculosis.
Prevention
Controlling the spread of tuberculosis infection can prevent tuberculous arthritis.
Patients who have a positive PPD test (but not active tuberculosis) may decrease their risk of tuberculous arthritis by properly taking medicines to prevent tuberculosis. To effectively treat tuberculosis, it is crucial that patients take their medications exactly as prescribed.
References
Alparsian L, Yu JS, Weissman BN. Imaging. In: Harris ED, Budd RC, Genovese MC, Firestein GS, Sargent JS, Sledge CB, eds. Kelley's Textbook of Rheumatology. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2005: chap 51.
McCune WJ, Golbus J. Monarticular arthritis. In: Harris ED, Budd RC, Genovese MC, Firestein GS, Sargent JS, Sledge CB, eds. Kelley's Textbook of Rheumatology. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2005: chap 34.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, PhD, MD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
