Musculoskeletal Tuberculosis: Two Year Experience at a Tertiary Care Teaching Hospital of Northern India and Review of Literature

Background: The aim of this study was to evaluate the present trend of osteo-articular tuberculosis at a teaching hospital in North India. Methods: All the cases of skeletal tuberculosis that were diagnosed and managed either on outdoor or in-hospital stay basis over a period of two years were evaluated with respect to age, gender, anatomical location of lesion, laboratory parameters (ESR, Mantoux test, HIV screening), concomitant skeletal tuberculous lesions, associated pulmonary tuberculosis, and other associated clinical features. Results: A total of 84 skeletal tuberculous lesions in 80 patients were enrolled for the study. The age of the patients ranged from 2 to 70 years with a mean of 29.1±19.1 years. 55% patients were in second and third decade of life and 63.7% were males. ESR was elevated in 61.25% and 56.25% tested positive for Mantoux skin test. 21.25% patients had associated active or healed focus of tuberculosis in the lungs. Spine was the most common site involved (58.75%) followed by hip (13.1%), knee (8.3%), foot (4.7%) and shoulder joint (3.5%). Lumbar spine was the most common site affected in the spine followed by lower dorsal spine. 3.75% cases had multifocal skeletal tuberculous lesions. Conclusion: Prevalence of osteo-articular tuberculosis continues to be high in North India with the disease predominantly affecting young population. Spine is the most common site for skeletal tuberculosis followed by hip, knee, foot and shoulder. Lumbar region followed by lower dorsal spine is much more affected. Multifocal skeletal lesions incidence is lower than expected. And one-fifth of the patients have associated pulmonary tubercular lesion.