TB

Prior to going to Fiji my knowledge of the pathological process of TB was not huge. I knew that it mostly affected the pulmonary system and that initial symptoms included haemoptosis. I was however very unaware of the effect it has on the musculoskeletal system. I patient presented to the hand clinic in Lautoka with a sore wrist. The wrist Xray was put up on the light box and it was obvious to see severe pathology in the wrist joint. The treating doctor then began asking questions to gain information on pulmonary symptoms. The patient had a long standing cough and had been coughing up bloody for the previous three weeks. I thought that you guys might be interested in the affect TB has on the musculoskeletal system so I looked it up.
Joint pathology caused by TB is called TB arthritis or Spondylitis, and is cause by prolonged infection in the joint.
Tuberculosis arthritis symptoms include:
Low-grade fever
Excessive sweating especially at night
Weight loss or loss of appetite
Joint swelling with warm, tender joints
Decreased joint mobility
Spinal mass, some times associated with numbness, tingling, or weakness of the legs

Long standing infection stimulates growth. You can imagine the pathology that would occur in a joint space with destruction of normal tissue and abnormal, weak tissue laid down in its place. Bone tissue growth is stimulated, fibrotic tissue is laid down and eventually, similar to rheumatoid arthritis, the joint space decreases and the joint fuses. On Xray the joint space will be decreased, look hazy or in late stages fused.