II. Definition
- Arthritis secondary to Mycobacterium tuberculosis
III. Epidemiology
- Occurs in 2% of Tuberculosis patients
- Represents 35% of Extrapulmonary Tuberculosis
IV. Findings: Distribution
- Spinal Tuberculosis (Pott's Disease)
- Spine is most common site of TuberculosisArthritis
- Thoracic Spine most commonly involved
- Associated with paraspinous abscess
- Destroys anterior Vertebral body and adjacent disc
- Results in anterior wedging
- Forms prominence of spine known as Gibbus
- May compress central cord
- Articular Tuberculosis
- Monoarticular Arthritis of weight bearing joints (Knee is most common joint involved, after spine)
- Presents with insidious monoarticular pain, swelling
- May form superficial abscesses and drain to skin
- Poncet's Disease (rare)
- Acute sterile Polyarthritis
- Associated with visceral involvement
- Tuberculous Osteomyelitis
- May involve any bone
V. Signs
- Doughy synovitis on joint palpation
- Develops very slowly (months to years)
VI. Labs
-
Tuberculin Skin Test (Purified Protein Derivative)
- Positive in most cases
-
Synovial Fluid Exam
- See Septic Arthritis
VII. Imaging: Chest XRay
- Pulmonary involvement in only 50% of Tb Arthritis
VIII. Diagnosis
-
Arthrocentesis with Mycobacterium tuberculosis culture
- Test Sensitivity: 80%
- Synovial biopsy
IX. Management
- See Extrapulmonary Tuberculosis
- See Tuberculosis Management
- Consult infectious disease
- Follow Tuberculosis Management guidelines and treat for 6 to 9 months
- Treatment starts with typically 4 drug regimen until susceptibilities available
- Regimens are similar to pulmonary Tuberculosis regimens, and typically contain Rifampin
X. References
- (2021) Bone and Joint Tuberculosis, Uptodate, accessed on IOS, 12/16/2021
- (2021) Sanford Guide, accessed on IOS, 12/16/2021
- Watts (1996) J Bone Joint Surg Am 78:288-98 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| Concepts | Disease or Syndrome (T047) |
| MSH | D014394 |
| ICD10 | M01.1 , A18.01 |
| SnomedCT | 7023007, 367488007, 201556004, 63712002, 186229002, 190710003 |
| English | Joint Tuberculoses, Tuberculoses, Joint, Tuberculosis, Joint, tuberculosis of a joint, tuberculosis of joint, tuberculosis of joint (diagnosis), joint tuberculosis, joints tuberculosis, Tuberculosis;joint(s), tuberculous arthritis, of joint tuberculosis, Tuberculous arthropathy (disorder), Joint tuberculosis, Joints--Tuberculosis, Tuberculous arthritis, Tuberculous arthropathy, Tuberculous rheumatism, Tuberculosis of joint, Tuberculosis of joint (disorder), Tuberculous arthritis (disorder), Tuberculosis of joint, NOS, Tuberculosis of joint (disorder) [Ambiguous], Tuberculous arthritis [Ambiguous], Tuberculous arthropathy -RETIRED-, Joint Tuberculosis, TB of the jointe |
| Italian | Tubercolosi articolare, Tubercolosi dell'articolazione |
| Japanese | 関節結核, ｶﾝｾﾂｹｯｶｸ |
| Portuguese | Tuberculose Articular, Tuberculose articular |
| Spanish | Tuberculosis Articular, tuberculosis de la articulación, artropatía tuberculosa - RETIRADO -, tuberculosis de la articulación (trastorno), artropatía tuberculosa - RETIRADO - (concepto no activo), reumatismo tuberculoso, artritis tuberculosa (trastorno), artritis tuberculosa, artropatía tuberculosa, reuma tuberculoso, tuberculosis articular (trastorno), tuberculosis articular, tuberculosis de la articulación (concepto no activo), Tuberculosis articular |
| French | Tuberculose articulaire, Tuberculose des articulations |
| German | Gelenktuberkulose, Tuberkuloese Arthritis |
| Czech | Tuberkulóza kloubů |
| Korean | 결핵성 관절염 |
| Hungarian | ízületi tuberculosis |
| Norwegian | Tuberkulose i ledd, Leddtuberkulose |
| Dutch | Tuberculeuze artritis, gewrichtstuberculose, Gewrichtstuberculose |
Ontology: Kyphosis deformity of spine (C0022821)
| Definition (MSH) | Deformities of the SPINE characterized by an exaggerated convexity of the vertebral column. The forward bending of the thoracic region usually is more than 40 degrees. This deformity sometimes is called round back or hunchback. |
| Definition (MSHCZE) | Vyklenutí páteře v předozadní rovině směrem dozadu. Přirozená k. je v hrudní oblasti. Srov. kyfoskolióza, lordóza, gibbus, řec. kyfos ohnutý, shrbený. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
| Definition (NCI) | Abnormally increased curvature of the thoracic portion of the spine. |
| Definition (NCI_CTCAE) | A disorder characterized by an abnormal increase in the curvature of the thoracic portion of the spine. |
| Concepts | Anatomical Abnormality (T190) |
| MSH | D007738 |
| ICD10 | M40.20 |
| SnomedCT | 88796005, 414564002, 298383008 |
| English | Kyphoses, Kyphosis, Angulation of spine, Kyphosis deformity of spine, Unspecified kyphosis, Kyphosis [Disease/Finding], gibbus, hunchback, kyphosis (diagnosis), kyphosis, round back, spine; angulation, angulation; spine, Gibbosity, Gibbus, Humpback, Hunchback, Kyphosis deformity of spine (disorder) |
| Japanese | 脊柱後弯症, ｾｷﾁｭｳｺｳﾜﾝｼｮｳ |
| Swedish | Kyfos |
| Czech | kyfóza, Kyfóza |
| Finnish | Kyfoosi |
| Russian | KIFOZ, КИФОЗ |
| Croatian | KIFOZA |
| Polish | Wygięcie kręgosłupa tylne, Kifoza |
| Hungarian | Kyphosis |
| Spanish | cifosis, giba, cifosis (trastorno), joroba, deformidad de la columna vertebral - cifosis (trastorno), deformidad de la columna vertebral - cifosis, Cifosis |
| Norwegian | Kyfose, Krumning av ryggsøylen, Pukkelrygg |
| Dutch | angulatie; wervelkolom, wervelkolom; angulatie, kyfose, Kyfose |
| French | Cyphose |
| German | Kyphose |
| Italian | Cifosi |
| Portuguese | Cifose |
Ontology: Tuberculosis, Spinal (C0041330)
| Definition (MSHCZE) | Pottova nemoc – tuberkulóza páteře vedoucí někdy ke vzniku hrbu (gibbu). (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
| Definition (MSH) | Osteitis or caries of the vertebrae, usually occurring as a complication of tuberculosis of the lungs. |
| Concepts | Disease or Syndrome (T047) |
| MSH | D014399 |
| ICD9 | 015.00, 015.0 |
| ICD10 | M49.0 , A18.01 |
| SnomedCT | 50509001, 186230007, 203262001, 35984006 |
| English | Disease, Pott, Pott Disease, Potts Disease, Spinal Tuberculoses, Spinal Tuberculosis, Tuberculoses, Spinal, Disease, Pott's, TB vertebral column - Pott's, Tuberculosis of spine, Tuberculosis of vertebral column, unspecified examination, TUBERCULOUS SPONDYLITIS, POTTS DIS, POTT DIS, Pott's disease (diagnosis), Tuberculosis of spinal cord, TB spine, Tuberculous spine, TB of vertebra-unspec, Tuberculosis, Spinal [Disease/Finding], Tuberculosis of vertebral column, unspecified, spine tuberculosis, disease pott's, pott's disease, potts disease, spinal cord tuberculosis, pott disease, spine tuberculous, tuberculous spondylitis, diseases pott, disease pott, spine tb, tb spine, tuberculosis spinal, spinal tuberculosis, diseases pott's, disease potts, Tuberculosis, Spinal, Pott's Disease, tuberculosis spine, tuberculosis of spine, tuberculosis of spine (diagnosis), Tuberculosis of spine (disorder), Tuberculous spondylitis (disorder), Spine--Tuberculosis, Tuberculous spondylitis, Tuberculosis of vertebral column, Pott's disease, Tuberculosis of vertebral column - Pott's, Tuberculosis of spine (Pott's), Tuberculosis of vertebral column (disorder), Pott; disease (etiology), Pott; disease (manifestation), disease (or disorder); spine or vertebra, tuberculous (etiology), disease (or disorder); spine or vertebra, tuberculous (manifestation), spine or vertebra; disorder, tuberculous (etiology), spine or vertebra; disorder, tuberculous (manifestation), Tuberculous spondylitis -RETIRED- |
| Dutch | ziekte van Pott, ruggengraattuberculose, wervelkolomtuberculose, wervelkolomtuberculose, niet-gespecificeerd onderzoek, tuberculeuze ruggengraat, TBC ruggengraat, tuberculose van ruggenmerg, Pott; ziekte, aandoening; wervel{kolom}, tuberculeus, wervel{kolom}; aandoening, tuberculeus, Tuberculose van wervelkolom, Pott, ziekte van, Tuberculose, spinale, Tuberculose, wervelkolom-, Wervelkolomtuberculose, Ziekte van Pott |
| French | TB rachidienne, Tuberculose de la moelle épinière, Rachis tuberculeux, Maladie de Pott, Tuberculose de la colonne vertébrale, examen non précisé, Tuberculose de la colonne vertébrale, Spondylodiscite tuberculeuse, Tuberculose vertébrale, Mal de Pott, Spondylite tuberculeuse, Tuberculose du rachis, Tuberculose rachidienne |
| German | Tuberkulose der Wirbelsaeule, Tuberkulose des Rueckenmarks, TB Wirbelsaeule, Tuberkulose der Wirbelsaeule, unspezifische Untersuchung, Pott-Krankheit, tuberkuloese Wirbelsaeule, Spinale Tuberkulose, Tuberkulose, spinale, Wirbelsäulentuberkulose |
| Italian | Tubercolosi del midollo spinale, Tubercolosi vertebrale, Tubercolosi della colonna vertebrale, esame non specificato, Tubercolosi della colonna vertebrale, Malattia di Pott, Tubercolosi spinale |
| Portuguese | Coluna vertebral com tuberculose, Mal de Pott, TB da coluna, Tuberculose da coluna vertebral, Tuberculose da medula espinhal, Tuberculose da coluna vertebral com exame NE, Doença de Pott, Tuberculose da Coluna Vertebral |
| Spanish | Tuberculosis de la médula espinal, Tuberculosis espinal, Tuberculosis de la columna vertebral, TB de columna, Tuberculosis de columna, Tuberculosis de la columna vertebral, estudio no especificado, espondilitis tuberculosa - RETIRADO - (concepto no activo), espondilitis tuberculosa - RETIRADO -, Tuberculosis Vertebral, Tuberculosis Espinal, enfermedad de Pott, espondilitis tuberculosa, tuberculosis de la columna vertebral (trastorno), tuberculosis de la columna vertebral, Enfermedad de Pott, Tuberculosis de la Columna Vertebral |
| Japanese | 脊髄結核, 脊柱結核、検査の詳細不明, 脊柱結核, ｾｷﾁｭｳｹｯｶｸ, ｾｷﾁｭｳｹｯｶｸｹﾝｻﾉｼｮｳｻｲﾌﾒｲ, ｾｷﾂｲｹｯｶｸ, ﾎﾟｯﾄﾋﾞｮｳ, ｾｷｽﾞｲｹｯｶｸ, 結核-脊椎, Pott病, ポット病, 脊椎結核, 結核性脊椎炎, 脊椎カリエス, 脊椎炎-結核性 |
| Swedish | Tuberkulos, spinal |
| Czech | tuberkulóza páteře, Tuberkulóza páteře, blíže neurčené vyšetření, Tuberkulózní zánět páteře, Tuberkulóza páteře, Pottova nemoc, TBC páteře, Tuberkulóza míchy |
| Finnish | Selkärankatuberkuloosi |
| Russian | TUBERKULEZ POZVONOCHNIKA, POTTA BOLEZN', POZVONOCHNIKA TUBERKULEZ, SPONDILIT TUBERKULEZNYI, ПОЗВОНОЧНИКА ТУБЕРКУЛЕЗ, ПОТТА БОЛЕЗНЬ, СПОНДИЛИТ ТУБЕРКУЛЕЗНЫЙ, ТУБЕРКУЛЕЗ ПОЗВОНОЧНИКА |
| Korean | 척추의 결핵 |
| Polish | Gruźlica kręgosłupa, Choroba Potta |
| Hungarian | Gerincoszlop tuberculosisa, gerinc tbc-s fertőzése, Gerincvelő tuberculosisa, gerinctuberculosis, Pott-betegség, Gerinc TBC, Gerincoszlop tuberculosisa, nem meghatározott vizsgálat |
| Norwegian | Tuberkuløs spondylitt, Spinal tuberkulose |
Ontology: Tuberculous osteomyelitis (C0275922)
| Concepts | Disease or Syndrome (T047) |
| ICD10 | A18.03 |
| SnomedCT | 186229002, 58764007 |
| English | Tuberculous osteomyelitis, tuberculous osteomyelitis, tuberculous osteomyelitis (diagnosis), tubercular osteomyelitis, Tuberculous osteomylelytis, Tuberculous osteomyelitis (disorder) |
| Spanish | osteomielitis tuberculosa (trastorno), osteomielitis tuberculosa |
