Clinical Outcomes of Delayed Osteoarticular Tuberculosis: A Review of 30 Cases

Abstract

Achmad Fauzi Kamal,1 Prima Rizky Oktari,1 Aryadi Kurniawan,1 Evelina Kodrat,2 Nadia Asmirtania Mumpuni3 1Department of Orthopedic and Traumatology, Faculty of Medicine, Universitas Indonesia, Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; 2Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; 3Pelni General Hospital, Jakarta, IndonesiaCorrespondence: Prima Rizky Oktari, Department of Orthopedic and Traumatology, Faculty of Medicine, Universitas Indonesia, Dr Cipto Mangunkusumo General Hospital, Jl Diponegoro No. 71, Central of Jakarta, Jakarta, Indonesia, Email [email protected]: The lack of knowledge regarding osteoarticular tuberculosis (TB) cases in Indonesia leads to delayed and chronic conditions. This study aims to evaluate clinical outcomes of patients with osteoarticular TB.Materials and Methods: Thirty osteoarticular cases were retrospectively analyzed, with a focus on non-immunocompromised patients without spine involvement. Chemotherapy length, operative treatment method, and infection recurrence were evaluated.Results: The majority (60%) of patients were aged between 19 to 49 years. The most common complaint was painful swelling, particularly during physical activity. Weight-bearing joints, such as the hips, knees, and ankles, were the most affected. Laboratory results showed over half of the patients had anemia, 96% had elevated erythrocyte sedimentation rate (ESR), and 76% had elevated C-reactive protein (CRP) levels. Radiological findings varied, with lytic lesions, abscesses, and joint destruction observed. All patients presented with pathognomonic histological tubercle appearances, with caseous necrosis, lymphocytes, and Langhans giant cells present. Twenty-nine cases were treated with anti-TB drugs for 12 months, while one recurrent case received the drugs for 24 months. All patients underwent surgery to gain local infection control.Conclusion: Osteoarticular TB is a common manifestation of extrapulmonary TB and must not be overlooked. Early detection of osteoarticular TB may prevent limb morbidity. Although anti-TB drugs are the primary treatment for osteoarticular TB, in some cases, surgery is required to establish a diagnosis and gain local infection control.Keywords: osteoarticular TB, tuberculosis, extrapulmonary TB, caseous necrosis, Jakarta

Keywords

• osteoarticular tb
• tuberculosis
• extrapulmonary tb
• caseous necrosis
• jakarta