• age
• clinical type
• gender
• involvement sites
• multifocal osteoarticular tuberculosis

• Humans
• Tuberculosis, Osteoarticular/epidemiology
• Tuberculosis, Osteoarticular/pathology
• India/epidemiology
• Male
• China/epidemiology
• Female
• Child
• Child, Preschool
• Adult
• Young Adult
• Adolescent
• Infant
• Infant, Newborn
• Middle Aged
• Prevalence

• Project for Public Health Talent Cultivation of China

• anti-tubercular therapy
• cuboid bone
• granulomatous inflammation
• mycobacterium tuberculosis
• osteoarticular tuberculosis
• tuberculosis

• knee osteoarthritis
• mycobacterium tuberculosis
• physical medicine and rehabilitation
• pigmented villonodular synovitis
• total knee arthroplasty

• Jakarta
• caseous necrosis
• extrapulmonary TB
• osteoarticular TB
• tuberculosis

• Pigmented villonodular synovitis
• Tuberculosis
• knee

Purpose: Bone and joint tuberculosis (BJTB) represents approximately 2-5% of all tuberculosis (TB) cases and its characteristics are infrequently discussed. The aim of this study was to examine the epidemiology, characteristics, and management of BJTB in Greece.

Methods: We conducted retrospective analyses of demographic clinical and treatment data accessed from medical records of patients with BJTB and with pulmonary involvement between 2011 and 2019 from the national TB reference hospital in Greece. Factors associated with treatment outcomes among patients were evaluated.

Results: Out of the total 3064 confirmed TB cases during the study period, 54 patients had either BJTB or skeletal TB with pulmonary involvement. The majority of patients were males (81.5%) and the mean age of the patients was 37.81±18.92 years. Out of the total patients, 11 were Greek and 43 were immigrants. Women had a higher probability of experiencing a stable or negative treatment outcome. Also, the patients that received therapy for less than nine months had 16.3 times higher probability of experiencing a stable or negative treatment outcome, compared to those that received therapy for more than 12 months.

Conclusions: The study indicated that the sex and the duration of treatment correlated with the treatment outcomes. It is essential to monitor and accurately report treatment outcomes so as to achieve disease control.

• Composite reference standard
• Extrapulmonary
• Gene Xpert assay
• Osteoarticular
• Tuberculosis

• Cuboid
• anti-tuberculous therapy
• osteomyelitis
• tarsal bone
• tuberculosis

Tuberculous osteomyelitis of the clavicle accounts for 1–3% of cases of osteoarticular tuberculosis. It presents with non-specific symptoms and may have superadded infections with pyogenic organisms, requiring a high degree of suspicion to adequately diagnose and initiate appropriate treatment.

We describe a case of a 35-year-old male with osteolytic clavicular lesion and abscess in the supraclavicular fossa. Tissue diagnosis revealed tuberculous osteomyelitis with superadded infection with Staphylococcus aureus. He was managed with debridement and anti-tubercular therapy.

A high degree of suspicion is required to adequately test and diagnose the cause of osteomyelitis of the clavicle, in the absence of a predisposing event, as staphylococcal and tuberculous infection can present simultaneously.

• Clavicle
• osteomyelitis
• tuberculosis

Ancient human remains exhibiting bony changes consistent with osteoarticular tuberculosis (OATB) indicate that the disease has afflicted mankind for millennia. Nonetheless, not many pediatric OATB cases have been published in the paleopathological literature–from Hungary, only three cases have been described up to now. In our paper, we demonstrate a child (S0603) from the Árpádian Age cemetery of Győrszentiván-Révhegyi tag (northwestern Hungary), who represents a unique case of OATB regarding both the pattern and severity of the observed bony changes. During the macromorphological and radiological investigations, the most serious alterations were discovered in the upper thoracic spine–the development of osteolytic lesions led to severe bone loss and consequent collapse and fusion of several adjacent vertebrae. The pathological process terminated in a sharp, rigid angular kyphosis. Disruption of the normal spine curvature resulted in consequent deformation of the whole thoracic wall–it became “rugby-ball-shaped”. The overall nature and pattern of the detected alterations, as well as their resemblance to those of described in previously published archaeological and modern cases from the pre-antibiotic era indicate that they are most consistent with OATB. Based on the severity and extent of the lesions, as well as on the evidence of secondary healing, S0603 suffered from TB for a long time prior to death. Besides body deformation, OATB resulted in consequent disability in daily activities, which would have required regular and significant care from others to survive. It implies that in the Árpádian Age community of Győrszentiván-Révhegyi tag, there was a willingness to care for people in need. Detailed archaeological case studies can give us a unique insight into the natural history and different presentations of OATB. Furthermore, they can provide paleopathologists with a stronger basis for diagnosing TB and consequently, with a more sensitive means of assessing TB frequency in past populations.

• Archaeology
• Cemeteries
• Child
• History, Medieval
• Humans
• Hungary
• Male
• Spine/pathology
• Tuberculosis, Osteoarticular/history
• Tuberculosis, Osteoarticular/pathology

• University of Szeged Open Access Fund
• National Research, Development and Innovation Office (Hungary)
• Hungarian Ministry of Human Capacities

• chest wall
• computed tomography
• sternoclavicular joint
• tuberculosis
• ultrasonography

There has been a major resurgence of tuberculosis (TB) and drug-resistant tuberculosis in the last few decades. Although it has been brought under control in most Western countries, it is still a major cause of death in endemic regions like India. Osteoarticular tuberculosis (OA TB) forms a small proportion of the total cases of tuberculosis. Perceptions and practices of orthopedic surgeons are entirely different in endemic and non-endemic regions around the world, due to the vast difference in exposure. Literature from endemic areas puts stress on clinico-radiological diagnosis and empirical anti-tubercular treatment (ATT). Such practices, although non-invasive, simple to implement, and economical, carry a significant risk of missing TB mimics and developing drug resistance. However, OA TB is still perceived as a “diagnostic enigma” in non-endemic regions, leading to a delay in diagnosis. Hence, a high index of suspicion, especially in a high-risk population, is needed to improve the diagnosis. Evolving drug resistance continues to thwart efforts to control the disease globally. This review article discusses the perceptions and practices in different parts of the world, with India as an example of the endemic world, and lays down priorities for overcoming the challenges of diagnosing osteoarticular TB.

• GeneXpert
• clinico-radiological diagnosis
• culture
• drug sensitivity
• drug-resistant tuberculosis
• endemic
• osteoarticular tuberculosis