Tuberculous arthritis Health Article

Definition

Tuberculous arthritis is an infection of the joints due to tuberculosis (TB).

See also: Spondylitis

Alternative Names

Granulomatous arthritis

Causes, incidence, and risk factors

Approximately small number of people who have TB will develop this form of arthritis. The joints most often involved are the:

• Ankles
• Hips
• Knees
• Spine
• Wrists

Most cases involve just one joint.

TB 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.

Signs 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 TB
• Chest x-ray
• CT scan of the spine
• Joint x-rays
• Tuberculin skin test (also called PPD)

Treatment

The goal of treatment is to cure the infection with drugs that fight the TB bacteria. Treatment of active pulmonary TB will always involve a combination of many drugs (usually four drugs). All of the drugs are continued until lab tests show which medicines work best.

The most commonly used drugs include:

• Isonizid
• Rifampin
• Pyrazinamide
• Ethambutol

Other drugs that may be used to treat TB include:

• Amikacin
• Ethionamide
• Moxifloxacin
• Para-aminosalicylic acid
• Streptomycin

You may need to take many different pills at different times of the day for 1 year or longer. It is very important that you take the pills the way your health care provider instructed.

Your doctor or nurse is required by law to report your TB illness to the local health department. Your health care team will be sure that you receive the best care for your TB.

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.