Tuberculosis

Abstract Chapter 89 reviews musculoskeletal tuberculosis (TB), which is an infectious disease caused by Mycobacterium tuberculosis. Extrapulmonary TB is seen in 20% of all TB cases. Musculoskeletal TB accounts for 1-3% of tuberculous infections. The most common musculoskeletal presentation is TB spondylitis followed by TB infectious arthritis, osteomyelitis, tenosynovitis, bursitis, and Poncet disease. Hematogenous dissemination of the organism from a visceral primary focus (lungs, kidneys, lymph nodes) to the musculoskeletal system is the most common pathway, but lymphatic spread or direct inoculation can also occur. Clinical findings are variable. Generally patients have low-grade fevers, night sweets, weight loss, anorexia, and malaise. Although radiography should be the initial imaging modality in evaluation of disease, MRI is the best modality in evaluation of musculoskeletal TB.