Granulomatous arthritis

Definition

Tuberculous arthritis is an infection of the joints due to tuberculosis.

See also: Spondylitis

Alternative Names

Causes

Approximately 2% of people affected with tuberculosis will develop associated arthritis

Tuberculosis involving the spine is often referred to as Pott's disease. The fictional Hunchback of Notre Dame had a humpback that is thought to have been caused by tuberculosis.

Tuberculous arthritis can be very destructive. In particular, if the spine is involved, a patient may have numbness, tingling, or weakness below the level of the infection. Muscle atrophy and muscle spasms can occur.

Symptoms

• Low-grade fever
• Excessive sweating, especially at night
• Weight loss or loss of appetite
• Joint swelling with warm, tender joints
• Decreased joint mobility
• Spinal mass, sometimes associated with numbness, tingling, or weakness of the legs

Exams and Tests

A physical examination indicates joint inflammation.

Tests:

• Joint x-rays
• Positive tuberculin skin test (also called PPD)
• Aspiration of fluid in the joint
• Biopsy of the joint to detect the bacteria that causes tuberculosis

Treatment

Antibiotics will be given to destroy the bacteria that are causing the tuberculosis infection.

Pain killers and application of heat or cold to the joints may provide relief of pain. Surgery may be necessary, especially to drain spinal abscesses or to stabilize the spine. Surgery is rarely needed for infections of other sites.

Outlook (Prognosis)

This form of arthritis can be very destructive to the tissues. Control of the infection should prevent further joint involvement. However, joint destruction may take place before the infection is controlled.

Possible Complications

• Vertebral collapse resulting in kyphosis
• Spinal cord compression
• Joint destruction

When to Contact a Medical Professional

Call your health care provider if you have symptoms suggestive of this disorder, or if other possible tuberculosis symptoms are present.

Prevention

Controlling the spread of tuberculosis infection can prevent tuberculous arthritis. Patients who have a positive PPD test (but not active tuberculosis) may decrease their risk of tuberculous arthritis by properly taking medicines to prevent tuberculosis. To effectively treat tuberculosis, it is crucial that patients take their medications exactly as prescribed.