Abstract
Objectives: Skeletal tuberculosis reports 1-5% of all TB cases. The most common sites of involvement are spine, knee and hip. The diagnosis of extra-pulmonary TB is difficult. The aim of this study was to show up the different way of diagnosis and report this kind of TB in Iran.
Method: This study was done in Masih Daneshvari Hospital, a referral center of TB in Iran, from 2003 to 2011. In this retrospective study, we extracted all skeletal TB. Demographic information, the method of diagnosis, and other information were evaluated.
Results: Of 426 extra-pulmonary TB, 58(13.6%) patients were skeletal TB. The mean age was 45.72±20.26yrs. 31(53.4%) patients were male. One patient was HIV positive. New cases of TB, relapse and history of TB treatment were 51, 4 and 3 respectively. Median of duration of symptoms was 7 months. 28 patients had pulmonary TB (sputum smear or culture was positive). The kind of skeletal TB was: 2patients with pleural, one patient with CNS, one patient with lymph node concomitant with spine and 52 patients just spine. Two patients were arthritis (knee) tuberculosis. Diagnostic method was: positive granuloma 43.7%, PCR positive 31.2%, positive smear and culture 43.7%, diagnosed by positive sputum for TB 31% and diagnosed by clinical/ magnetic resonance imaging 13.7%.
Conclusion: The diagnosis of skeletal TB is difficult and it will take time to detect it. Investigation of other involved site such as lungs, pleura or lymph nodes can help us early TB diagnosis.
- © 2012 ERS