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Semin Musculoskelet Radiol 2011; 15(5): 459-469
DOI: 10.1055/s-0031-1293492
© Thieme Medical Publishers

Tuberculosis Arthritis and Tenosynovitis

Nuttaya Pattamapaspong1 , Malai Muttarak1 , Chate Sivasomboon1
  • 1Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Publication Date:
11 November 2011 (online)

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ABSTRACT

The incidence of extrapulmonary tuberculosis (TB) has been rising due to the increasing number of immunosuppressed patients. Musculoskeletal system accounts for 25% of extrapulmonary TB. Most of the musculoskeletal TB involves the spine. TB of peripheral joints and tendons occur infrequently, but if untreated, it can cause serious joint and tendon destruction as well as spread of the infection to the surrounding bursa, muscle, and other soft tissues. The diagnosis of TB of joints and tendons is difficult due to the nonspecific clinical manifestations and imaging features. Concurrent active pulmonary TB is present in <50% of the patients. A positive chest radiographic finding or a positive tuberculin test supports the diagnosis, but negative results do not exclude diagnosis. Although imaging features of TB of joints and tendons are nonspecific, certain findings such as relatively preserved joint space, juxta-articular osteoporosis, cold abscesses, para-articular soft tissue calcification, and rice bodies are suggestive of TB infection. Familiarity with these imaging features can help in making an early diagnosis and facilitating proper management.

KEYWORDS

Infective tenosynovitis - Mycobacterium tuberculosis - septic arthritis - tuberculosis - tuberculous arthritis

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Nuttaya PattamapaspongM.D. 

Department of Radiology, Faculty of Medicine, Chiang Mai University

110 Intavaroros Road, Chiang Mai 50200, Thailand

Email: nuttaya@gmail.com