Skeletal Tuberculosis in Pediatric Population for 15 Years; Twenty Cases from Southern Turkey

Abstract

Background: Skeletal tuberculosis is rarely seen among extrapulmonary  tuberculosis, especially in childhood because the diagnosis may be delayed for years  due to diagnostic difficulties. In this study, it was aimed to evaluate the clinical  characteristics, methods used in diagnosis, treatment specifics, and  prognosis of patients diagnosed with bone joint tuberculosis in childhood.  

Materials and Methods: Twenty patients diagnosed with skeletal tuberculosis in  our hospital between Jan 1, 2006, and Jan 1, 2021, were evaluated retrospectively.   

Results: The age of the patients ranged from seven to 191 months. 70% of the  patients presented with complaints of pain, 50% with swelling, and 20% with  limping. The duration of the complaints was 3.82 ± 4 months on average. While 65%  of the patients had isolated skeletal TB, 30% were accompanied with pulmonary  tuberculosis. Tuberculin skin test (TST) was positive in 13 (65%) patients. Seven (35%)  of the patients were diagnosed with proven TB. The most frequent  involvement was seen in knee bones (25%), followed by vertebra (15%), foot (15%),  and wrist (15%) bones. In the radiological findings, 65% of the patients had mass,  45% destruction, 35% enhancement/edema, 5% calcification/sclerosis, 5% cyst, and  35% soft tissue abscess. In the follow-up, 50% of the patients recovered without  sequelae. 

Conclusion: Skeletal tuberculosis can easily be missed in childhood due to  its slow insidious course, non-specific symptoms, and bone findings, resulting in  delayed diagnosis and may lead to sequelae which affect lifelong quality of life. We  should keep the possibility of skeletal tuberculosis in mind when we see the patients  with limping or localized lesions accompanied with pain or swelling.