• Title/Summary/Keyword: Tuberculous arthritis

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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.

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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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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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.

A Case of Chronic Arthritis Due to Mycobacterium intracellulare after Trauma (외상 후 발생한 Mycobacterium intracellulare에 의한 만성 관절염 1예)

  • Kim, Jae-Gyung;Kim, Dae-Won;Cho, Yul-Hee;Yim, Sun-Mie;Kang, Ju-Hyun;Joo, Young-Bin;Kang, Hyeon-Hui;Song, Jeong-Sup;Yoon, Hyoung-Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.191-196
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    • 2012
  • While nontuberculous mycobacterium (NTM) infections are recently on the rise, arthritis caused by NTM is hardly reported in Korea. NTM arthritis has no distinctive clinical characteristics from chronic arthritis. Tuberculosis of the joint specifically produces similar clinical and pathologic presentations to NTM arthritis, so it is not easy to distinguish between them. We report a case of Mycobacterium intracellulare in an arthritis patient after trauma and surgical repair of the injury. At the beginning, the patient was diagnosed as tuberculous tenosynovitis through pathology without microbiologic evidence. The final diagnosis was made after subsequent recurrences for several years. The misdiagnosis and delayed diagnosis led to irreversible joint destruction and functional impairment. NTM infection must be included in the differential diagnosis of chronic arthritis at the outset.

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.

A literatual studies on the Ong-Jeo in the special consideration of etiology and pathologic mechanism (癰疽에 대한 文獻的 考察;(病因.病機를 중심으로))

  • Roh, Hyun-Chan;Roh, Seok-Seon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.13 no.2
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    • pp.20-50
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    • 2000
  • This paper was written into condsideration records about the definition of "Ong-Jeo", the difference between "Ong" and "Jeo", the Western medical approach to "Ong-Jeo", and the etiology and pathologic mechanism of "Ong-Jeo". After this study, I report the following results from it. 1. "Ong" is an acute diapyesis disease which is found is in our skin and muscle and flesh. The chrateristics of this disease is that the affacted site is shine, no head, and the size is 3-4 chon. The prossess of the diesease shows that it is very quick, and very easily swell, and becomes pus easily, easily become to ulcer, easily converge. But this don't damage to the muscle and bone. 2. "Jeo" is the disease which damages bone-skeleton, muscle and flesh, and even destroy the stationary tissue. Jeo can be divided into two. One is called "Yudujeo" and it is acute diapydesis disease. The characteriscs of this disease is the miliary abscess, swell, has fever, and has an ache which is feeled spaned. And this is diffused into periphrey tissue and is diffused into deep site. After the ulcer, this becomes to shape the cellula. The size is more than 3-4 chon and this disease goes into chuk if this is serious. The other one is called "Mudujeo" and this disease is the ulcerative one in our joint and skeleton. The characteristic of this disease shows that the color of skin be not changed, and swell diffusely, and is not easily vanished, not easily becomes ulcerative, and not easily becomes converged. 3. "Ong-Jeo" is caused by the bacteriunm named by the "Golden and Yeollw Staphylococcus" in the Western medicine. "Ong" can be applicable to the carbuncle, acute diapyesis lymphadenitis, and some of cellulitis. "Jeo" can belong to cellulitis, and Mudujeo can belong to suppurative arthritis, suppurative osteomyelitis, tuberculous arthritis and osteomyelitis, and tuberculous lymphadenitis. 4. The etiologies of "Ong-Jeo" can be divided three, which are internal, external and other etiology which can not be clasiffied by two etiologies above. The internal etiology is seven emotion, and the external etiology is the six eumsa, unki, chunhang and so on. Other etiology is inadequate absorption of food, and excessive bang-sa. 5. The etiology of "Ong" is suppurative one which is choked between our skin and muscle and flesh, and is congested, become to hot, and finally erodes the muscle and flesh because of the inbalance of cirrculation in the enegy and blood. "Jeo" is the same as the Ong, but this is the suppurative disease which damages the muscle, flesh, and skeleton, and even damages into five Zang, the internal intestine.

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Synovial Lesions with Low Signal Intensities on T2-Weighted MR Image (T2 강조 MR 영상에서 저신호강도를 보이는 윤활막 질환)

  • Choo, Hye-Jung;Lee, Sun-Joo;Cho, Kil-Ho;Suh, Kyung-Jin;Lee, Sung-Moon;Lee, Young-Hwan;Lee, In-Sook;Lee, Gyung-Kyu;Kim, Bo-Mi
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.1
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    • pp.1-10
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    • 2011
  • Pigmented villonodular synovitis, synovial chondromatosis, long-standing rheumatoid arthritis, hemophilic arthropathy, chronic tophaceous gout, amyloid arthropathy, tuberculous arthritis, and hemangioma are the synovial diseases showing low signal intensity on T2-weighted image. Synovial deposition of hemosiderin, urate, and amyloid and fibrosis or caseous necrosis of hypertrophied synovium are known as the pathologic causes of T2 signal intensity. Because of the low incidence of the synovial lesions showing T2 low signal intensity, recognition of these diseases would be helpful for the exact diagnosis.

Arthroscopic Ankle Arthrodesis (관절경하 족근관절 고정술)

  • Bae Dae Kyung;Yoon Kyoung Ho;Ko Byoung Won;Cho Nam Su
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.148-153
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    • 2000
  • Purpose : This study was conducted to analyze the results of arthroscopic ankle arthrodesis and to verify the advantages of the technique compared to open ankle arthrodesis. Materials and Methods : Between October 1992 and August 1996, the arthroscopic ankle arthrodesis had been performed in five patients(six ankle joints): two patients with seropositive rheumatoid arthritis(one patient surgically treated bilaterally), two with osteoarthritis and one with tuberculous arthritis. There were one man and 4 women. Average age was 48 years ranging from 38 to 65 years. Follow up period was average 45 months(range, $12\~80$). Results : All patients were successfully treated with ankle joint arthrodesis under arthroscopic control. The mean time to fusion was 10 weeks(range, $6\~15$). There was a $100\%$ fusion rate without any complication. Conclusion : The arthroscopic ankle arthrodesis was successful in all cases with less morbidity and short hospital stay. It was technically feasible with excellent predictability.

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