Musculoskeletal Tuberculosis in Children

Paediatric musculoskeletal tuberculosis is very important to understand as it shares similar clinical, radiological and hematologocal findings with other infectious and non-infectitious conditions . It has become a major health hazard because of its association with immunocompromised states like HIV, Diabetes mellitus and chronic renal and liver diseases. Diagnosis is delayed in paediatric musculoskeletal tuberculosis because of lack of awareness of disease , non-specific clinical and laboratory findings. TB culture is considered as the gold standard in diagnosing tuberculosis and also, detecting drug sensitivity. Because of its potential for multi-drug resistance, there is a dilemma regarding drug of choice and duration of treatment. Surgery is reserved for obtaining samples to establish diagnosis, debridement and sequestrectomy in recalcitrant infections and correction of deformities to restore joint function. This review article briefs about classical clinical presentation, atypical and multifocal musculoskeletal tuberculosis, radiological and laboratory investigations and management of paediatric musculoskeletal tuberculosis. Musculoskeletal tuberculosis should be kept as a differential diagnosis when managing a case of musculoskeletal infection in children because of its non- specific presentation. Imaging such as MRI and advanced microbiological analysis aids in arriving correct diagnosis. Multidrug chemotherapy is mainstay of treatment. Radical curettage and, antituberculous chemotherapy followed by a period of immobilisation and rehabilitation will give excellent results Keywords: Paediatric musculoskeletal tuberculosis, multifocal tuberculosis, Tubercular osteomyelitis