Health Encyclopedia

Tuberculous arthritis

Definition

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

Alternative Names

Granulomatous arthritis

Causes, incidence, and risk factors

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.

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 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.

Expectations (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.

Complications

Collapse of the vertebrae, resulting in kyphosis
Joint destruction
Spinal cord compression

Calling your health care provider

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.

Review Date:9/17/2008
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.

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