• Title/Summary/Keyword: 결핵성 관절염

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The Surgical Treatment of Pyogenic and Tubercular Infection in the Sternoclavicular Joint - Case Report - (흉쇄관절에 발생한 화농성 관절염과 결핵성 관절염의 수술적 치료 - 증례 보고 -)

  • Kim, Young-Yul;Kwon, Jong-Beum;Lee, Yeon-Soo;Kim, Sang-Il;Ji, Jong-Hun
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.99-105
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    • 2010
  • Purpose: Here we report clinical results for surgical treatment of 2 cases of pyogenic arthritis and 1 case of tubercular arthritis, which only rarely develops in the sternoclavicular joint. Materials and Methods: From September 2003 to September 2008, we did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle in 3 patients and evaluated clinical results after short-term follow up. Results: All 3 patients were satisfied with their clinical results and none had any recurrences according to follow up X-rays and laboratory datas. The follow up MRI showed bone edema in the distal clavicle and proximal sternum and a little fluid retention around the sternoclavicular joint. Conclusion: Even though diagnosis of these diseases are made earlier, infection of the adjacent bone and osteomyelitis could already have developed. We did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle and achieved satisfactory results.

Operative Treatment of the Tuberculous Arthritis on the Sternoclavicular Joint - A Report of Two Cases- (흉쇄 관절에 발생된 결핵성 관절염의 수술적 치료 - 2예 보고 -)

  • Park, Jin-Young;Kim, Jeong-Woo;Chun, Churl-Hong;Kwon, Seok-Hyun;Choi, Yun-Hong;Lee, Seok-Jung
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.57-61
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    • 2008
  • Tuberculous arthritis on the sternoclavicular joint is an uncommon disease and a delayed diagnosis can be due to the obscure clinical symptoms. We should suspect tuberculous arthritis in patients with slowly progressive pain, swelling, mild fever and a previous history of tuberculosis. Early diagnosis is important through conducting a thorough physical examination and performing laboratory tests and radiologic study. Tuberculous arthritis on the sternoclavicular joint should be treated with a combination of systemic antituberculous agents and thorough surgical debridement in marked damaged joints. When performing this operation, it is important not only to minimized the injury of the costoclavicular ligament, but also to avoid injury to the surrounding the vital structures such as the mediastinum and pleura after aggressive resection or radical debridement. We describe here 2 cases of the tuberculous arthritis on the sternoclavicular joint: one case had a good result after surgical debridement with using an anti-tuberculous agent, and the other had fatal complications such as mediastinal abscess and pleural effusion after the operation.

Arthroscopic Treatment of Mixed Pyogenic and Tuberculous Arthritis of Shoulder Joint (견관절의 화농성 및 결핵성 복합 관절염의 관절경적 치료 - 증례보고 -)

  • Ko, Sang-Bong;Kim, Shin-Keun;Choi, Won-Kee;Park, Jae-Hyun;Choi, Chang-Hyuk
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.129-133
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    • 2008
  • Although the incidence of tuberculosis has been decreased due to new anti-tuberculous agents, improved socioeconomic status and development of multimodal preventive methods, in recent that is increased due to low vaccination rate and appearance of multidrug resistence organism. And the incidence of pyogenic shoulder joint arthritis is increasing due to frequent injection therapy as primary treatment. We have managed the mixed shoulder joint arthritis-pyogenic and tuberculous-with arthroscopic debridement and antituberculous medication successfully and then we report this case with relevant literatures.

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A Case of Tuberculous Arthritis on Left Knee Joint in a Child (소아에서 발생한 슬관절의 결핵성 관절염)

  • Lee, Hye Jin;Lee, Ji Hun;Mok, Hye Rin;Lee, Soo Young;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.174-179
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    • 2006
  • Tuberculosis still ranks as one of the three most important infectious diseases in the world in terms of morbidity and mortality. In Korea, an increased incidence of tuberculosis has been observed in recent years. With the resurge of tuberculosis, extrapulmonary tuberculosis has increased, too. From this point of view, tuberculous arthritis affecting knee is rare in all forms of tuberculosis, but we can consider tuberculous arthritis in patients with osteomyelitis. We report the case of a 14-month-old male child who presented with fever and swelling on the left knee joint. Histologic examination of knee joint fluid showed consistent with tuberculosis. Ziehl-Neelsen stain of joint fluid was positive for acid-fast bacilli(AFB). The outcome was favorable after treatment with anti-tuberculosis medication. Because clinical signs and symptoms of musculoskeletal tuberculosis in children is more indolent, we can misdiagnose or delay diagnosis. The diagnosis of tuberculous arthritis can be elusive, necessitating a high index of suspicion.

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Multimodal Diagnostic Approach for Synovitis of the Wrist (수근관절 활액막염 원인 질환 진단을 위한 다중적 접근법)

  • Bae, Kee Jeong;Kim, Jihyeung;Yoon, Chan;Hong, Seong Hwa;Gong, Hyun Sik;Baek, Goo Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.540-546
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    • 2018
  • Purpose: The purpose of this study was to suggest a multimodal diagnostic approach to determine the cause of the disease in patients diagnosed with synovitis of the wrist and who underwent synovectomy. Materials and Methods: Twenty-nine patients, who underwent contrast magnetic resonance imaging (MRI) preoperatively and synovectomy from January 2000 to December 2013, were reviewed retrospectively. Among them, 17 patients underwent a $Tc^{99m}$ white blood cell (WBC) scan preoperatively. In patients who met the diagnostic criteria of rheumatoid arthritis (RA), the diagnosis was confirmed as RA if the MRI finding or histology was compatible with RA. If the MRI finding and histology were disparate, the final diagnosis was made based on the histologic finding. Results: Of the nine patients who met the diagnostic criteria of RA, seven patients were finally diagnosed as RA and two patients as tuberculous arthritis. Of the 20 patients who did not meet the diagnostic criteria of RA, the MRI findings and histology were consistent with the same disease in 12 patients. In the remaining eight patients, five were diagnosed with nonspecific chronic synovitis, one with RA, and two with tuberculous arthritis based on the clinical findings, MRI, and histology findings. Conclusion: MRI and a WBC scan are very useful imaging modalities for diagnosing the causative condition of the wrist synovitis. A histology evaluation after synovectomy can also be useful in cases with a difficult diagnosis or are refractory to medications.

Acute Low Back Pain from Coexisting Gout and Tuberculous Spondyloarthropathy (급성 요통을 일으킨 결핵과 통풍이 혼재된 척추관절병증)

  • Park, Yung;Ha, Joong Won;Kwon, Ji-Won;Eum, Kwangsik
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.351-356
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    • 2021
  • A 67-year-old male patient with a history of epididymectomy and anti-tuberculosis treatment for epididymis tuberculosis was admitted for acute low back pain and radiating pain. The patient had no history of gout but showed hyperuricemia and a bone destruction lesion in the facet joint and lamina of the lumbar spine. A histology examination was performed after a computed tomography-guided needle biopsy, and the findings were compatible with gout spondyloarthropathy and tuberculous spondylitis. The acute symptoms improved after conservative treatment for gouty arthritis. When patients with hyperuricemia risk factors, such as taking anti-tuberculosis drugs, complain of acute low back pain, gout spondyloarthropathy should be considered in a differential diagnosis.

Tuberculous Subdeltoid Bursitis - A Case Report - (결핵성 삼각근하 점액낭염 - 증례 보고 -)

  • Lee, Woo-Seung;Yoon, Jung-Ro;Kang, Kyu-Bok;Yang, Jae-Hyuk;Lim, Hyung-Tae
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.45-48
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    • 2010
  • We report a case of an 85-year-old woman with tuberculous subdeltoid bursitis. Tubeculous bursitis without adjacent joint tuberculosis may occur any site but it is rare. It is common in bursae subjected to trauma like trochanteric, prepatellar, olecranon and so on. Because the clinical findings or physical examination of tuberculous subdeltoid bursitis are similar to rotator cuff disorder and the MRI or arthroscopic findings are similar to synovial diseases, careful differential diagnosis is necessary.

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Chronic Multiple Gouty Arthritis Diagnosed during Anti-Tuberculosis Treatment of Recurrent Tuberculous Arthritis: A Case Report (재발성 결핵성 관절염의 항결핵제 치료 중 진단된 만성 다발성 통풍성 관절염: 증례 보고)

  • Oh, Hyun Cheol;Choi, Yoon Jung;Ha, Joong Won;Park, Sang Hoon;Kim, Sang Hee;Yoon, Han Kook
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.116-119
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    • 2018
  • Gout occurs mainly in monoarthritis and is found in more than 50% of cases in hallux of the foot. In addition, symptoms sometimes begin in the hand, wrist, and elbow, but they are rarely observed in the spine. The patient was referred for tuberculous polyarthritis due to antituberculosis drug failure. Inflammatory findings were observed in the lumbar, elbow, wrist, hand and foot areas. Surgery was performed on the foot area and a pathology diagnosis revealed gouty arthritis. We report this case with a review of the relevant literature.