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RMJ. 2019; 44(4): 721-724

Clinical patterns of osteoarticular tuberculosis in children

Ejaz u Rahman, Shabeeta Bai, Nida, Masroor Ahmed, Rukhsana Hamid, Mukesh Kumar.

Objective: To evaluate the age group, most commonly involved bones and joints and clinical patterns of osteoarticular tuberculosis (TB) in children.
Methodology: This descriptive case series was performed at Pediatric & Orthopedic departments, Creek General Hospital, Karachi. Detailed clinical history and thorough physical examination were recorded. Patients had relevant investigations including complete blood count, ESR, Monteux test, gastric aspirate for acid fast bacilli, x-rays, MRI, CT scan, tissue for biopsy and culture of bone and synovial or fine needle aspiration cytology, as indicated by history and physical examination.
Results: A total of 50 children of bone and joint tuberculosis were included. The average age of the children was 6.83.25 years. 24(48%) children were male and 26(52%) were female. Joint pain was the leading complaint in 72% children, followed by joint swelling in 66%. Out of 50 children, 25(50%) had tuberculosis of joint, 18(36%) had TB of small and long bones, 3(6%) and 4(8%) had TB of knee and hip joint and 16(32%) had TB of ankle joint. TB of tibia was found in 2(4%), foot in 2(4%), rib in 1(2%) and femur in 1(2%) child.
Conclusion: The most commonly involved part of skeleton was spine. Monoarticular involvement was more common, particularly knee and hip joints. Involvement of joints of the upper limbs was least common. High index of suspicion is mandatory for the early diagnosis of the disease, which is often delayed due to vague clinical symptoms, co-infection with pyogenic bacteria and non-specific radiographic findings.

Key words: Children, osteoarticular tuberculosis, clinical patterns.

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