Delays in the diagnosis and treatment of bone and joint tuberculosis in the United Kingdom

The Bone & Joint Journal
C BroderickS Warren

Abstract

Tuberculosis (TB) infection of bones and joints accounts for 6.7% of TB cases in England, and is associated with significant morbidity and disability. Public Health England reports that patients with TB experience delays in diagnosis and treatment. Our aims were to determine the demographics, presentation and investigation of patients with a TB infection of bones and joints, to help doctors assessing potential cases and to identify avoidable delays. This was a retrospective observational study of all adults with positive TB cultures on specimens taken at a tertiary orthopaedic centre between June 2012 and May 2014. A laboratory information system search identified the patients. The demographics, clinical presentation, radiology, histopathology and key clinical dates were obtained from medical records. A total of 31 adult patients were identified. Their median age was 37 years (interquartile range (IQR): 29 to 53); 21 (68%) were male; 89% were migrants. The main sites affected were joints (10, 32%), the spine (8, 26%) and long bones (6, 19%); 8 (26%) had multifocal disease. The most common presenting symptoms were pain (29/31, 94%) and swelling (26/28, 93%). 'Typical' symptoms of TB, such as fever, sweats and weight loss, were u...Continue Reading

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Citations

Apr 10, 2018·The Bone & Joint Journal·R N Dunn, M Ben Husien
May 1, 2019·The Bone & Joint Journal·R N DunnM Held
Mar 17, 2020·Medicine·Ruohui TangJun Fei
Jun 20, 2020·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Jun FanYu Pang
Aug 20, 2020·Disability and Rehabilitation·Filippo MaselliMarco Testa
Aug 21, 2020·The Journal of International Medical Research·Xuehua WuFengfeng Wu
Aug 9, 2020·Journal of Clinical Medicine·Aurélie GuillouzouicPascale Bémer
Dec 31, 2019·The Journal of Infection·Ian M Head, Rajeka Lazarus
Apr 7, 2020·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Changgui ZhangXiaojun Duan
Mar 9, 2021·Journal of Clinical Tuberculosis and Other Mycobacterial Diseases·Sarah JacksonCatherine Comiskey
Oct 12, 2021·Open Forum Infectious Diseases·Carson K L LoEvan W Wilson

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