Skeletal Tuberculosis in Pediatric Population for 15 Years; Twenty Cases from Southern Turkey

Abstract

Background: Skeletal tuberculosis is rarely seen among extrapulmonary tuberculosis, especially in childhood because the diagnosis may be delayed for years due to diagnostic difficulties. In this study, it was aimed to evaluate the clinical characteristics, methods used in diagnosis, treatment specifics, and prognosis of patients diagnosed with bone joint tuberculosis in childhood.

Materials and methods: Twenty patients diagnosed with skeletal tuberculosis in our hospital between Jan 1, 2006, and Jan 1, 2021, were evaluated retrospectively.

Results: The age of the patients ranged from seven to 191 months. 70% of the patients presented with complaints of pain, 50% with swelling, and 20% with limping. The duration of the complaints was 3.82 ± 4 months on average. While 65% of the patients had isolated skeletal TB, 30% were accompanied with pulmonary tuberculosis. Tuberculin skin test (TST) was positive in 13 (65%) patients. Seven (35%) of the patients were diagnosed with proven TB. The most frequent involvement was seen in knee bones (25%), followed by vertebra (15%), foot (15%), and wrist (15%) bones. In the radiological findings, 65% of the patients had mass, 45% destruction, 35% enhancement/edema, 5% calcification/sclerosis, 5% cyst, and 35% soft tissue abscess. In the follow-up, 50% of the patients recovered without sequelae.

Conclusion: Skeletal tuberculosis can easily be missed in childhood due to its slow insidious course, non-specific symptoms, and bone findings, resulting in delayed diagnosis and may lead to sequelae which affect lifelong quality of life. We should keep the possibility of skeletal tuberculosis in mind when we see the patients with limping or localized lesions accompanied with pain or swelling.