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Skeletal tuberculosis in children in the Western world: 18 new cases with a review of the literature.
MedLine Citation:
PMID:  19543761     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: The occurrence of pediatric skeletal (extra-spinal) tuberculosis in the developed world is extremely rare. The purpose of this study was to review the cases at our institutions.
METHODS: We performed a retrospective review of all pediatric biopsy-proven skeletal (extra-spinal) cases of tuberculosis over a five-year period.
RESULTS: Eighteen patients of biopsy-proven tuberculosis were identified. The mean age was 12 years (range 7-20). Lesion locations included: distal humerus, ulna, scapula, acetabulum, proximal femur, proximal tibia, distal tibia, and calcaneus. All had symptoms of pain, swelling, and stiffness. Five cases had multi-focal involvement. Twenty-four lesions were noted in 18 patients. Nineteen lesions were cystic in nature at presentation. The sedimentation rate was normal in six and purified protein derivative (PPD) was negative in five patients. All received chemotherapy. Six patients underwent surgery.
CONCLUSIONS: The diagnosis of pediatric skeletal tuberculosis can be made with good correlation of clinical, radiographic, and laboratory findings. Biopsy and culture are the gold standards in diagnosis. Prognosis is good with chemotherapy and non-operative management. Surgical intervention may be needed in select cases.
Authors:
Harish S Hosalkar; Nina Agrawal; Swapna Reddy; Kriti Sehgal; Edward J Fox; Robert A Hill
Publication Detail:
Type:  Journal Article     Date:  2009-06-19
Journal Detail:
Title:  Journal of children's orthopaedics     Volume:  3     ISSN:  1863-2521     ISO Abbreviation:  J Child Orthop     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101313582     Medline TA:  J Child Orthop     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  319-24     Citation Subset:  -    
Affiliation:
Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 2 Silverstein, Philadelphia, PA, 19104, USA, hhpedpod@gmail.com.
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