Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd Logo
Upload

Welcome to Scribd!

  • 1K views

    Tuberculosis of Knee

    Uploaded by

    Jithin Bhagavati Kalam
    Tuberculosis of the knee can begin as an infection of the bones of the knee joint (osseous tuberculosis) or the synovial membrane (synovial tuberculosis). In early stages, the disease is confined to the synovium with no significant joint damage. In late stages, the articular cartilage and bone are destroyed, leading to synovial hypertrophy, effusion, pus formation and cartilage detachment. This can result in deformity of the knee through flexion, subluxation and external rotation. Treatment aims to achieve a painless mobile joint through conservative treatment including antibiotics and physical therapy or operative options like synovectomy, debridement or arthrodesis in advanced cases.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd

    Tuberculosis of Knee

    Uploaded by

    Jithin Bhagavati Kalam
    1K views17 pages
    Tuberculosis of the knee can begin as an infection of the bones of the knee joint (osseous tuberculosis) or the synovial membrane (synovial tuberculosis). In early stages, the disease is confined to the synovium with no significant joint damage. In late stages, the articular cartilage and bone are destroyed, leading to synovial hypertrophy, effusion, pus formation and cartilage detachment. This can result in deformity of the knee through flexion, subluxation and external rotation. Treatment aims to achieve a painless mobile joint through conservative treatment including antibiotics and physical therapy or operative options like synovectomy, debridement or arthrodesis in advanced cases.

    Original Description:

    Jithin BK Govt Medical College Thrissur

    Original Title

    Tuberculosis of Knee.pptx

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Tuberculosis of the knee can begin as an infection of the bones of the knee joint (osseous tuberculosis) or the synovial membrane (synovial tuberculosis). In early stages, the disease is confined to the synovium with no significant joint damage. In late stages, the articular cartilage and bone are destroyed, leading to synovial hypertrophy, effusion, pus formation and cartilage detachment. This can result in deformity of the knee through flexion, subluxation and external rotation. Treatment aims to achieve a painless mobile joint through conservative treatment including antibiotics and physical therapy or operative options like synovectomy, debridement or arthrodesis in advanced cases.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    1K views17 pages

    Tuberculosis of Knee

    Uploaded by

    Jithin Bhagavati Kalam
    Tuberculosis of the knee can begin as an infection of the bones of the knee joint (osseous tuberculosis) or the synovial membrane (synovial tuberculosis). In early stages, the disease is confined to the synovium with no significant joint damage. In late stages, the articular cartilage and bone are destroyed, leading to synovial hypertrophy, effusion, pus formation and cartilage detachment. This can result in deformity of the knee through flexion, subluxation and external rotation. Treatment aims to achieve a painless mobile joint through conservative treatment including antibiotics and physical therapy or operative options like synovectomy, debridement or arthrodesis in advanced cases.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 17

    TB Knee

    Jithin.B.K

    The disease may begin as

    Osseous tuberculosis
    Tibial condyle Femoral condyle Patella (rare)

    Synovial

    tuberculosis

    In the early stages of the disease


    Disease

    is confined to the synovium. No significant damage to the joint.

    In the late stages of the disease


    Articular cartilage and bone are destroyed. Synovial hypertrophy. Synovial effusion. Pus formation. Cartilage gets detached leaving the bone exposed.

    Late stages (Contd)


    Associated destruction of ligaments. Results in typical Triple displacement of Tibia.

    (Tibial flexion, posterior subluxation, and external rotation).

    Pus may burst out of capsule to present as a cold abscess, and subsequently a sinus.

    Clinical Features
    Age group 10-25 years. Pain and swelling in the knee. Gradual onset w/o any history of trauma. Subsequently, pain increases and knee takes an attitude of flexion. Patient starts limping. Severe stiffness to the knee.

    On examination
    Swollen joint. Muscular atrophy. Cold abscess. Discharging or healed sinus. Limited movements. Deformity of joint.

    Mild flexion deformity in early stages. Triple displacement deformity in late stages.

    Investigations:

    Radiological investigations
    Soft tissue shadow corresponding to distended knee. Wider joint space. Diffuse osteoporosis. Juxta-articular lytic lesions. Joint surface erosion. Joint space diminished or lost. Triple subluxation with cavitatory bone lesions in advanced stages.

    Other investigations
    Blood examination: Lymphocytic leucocytosis, high ESR. Mantoux test. Serum ELISA to detect antimycobacterium antibodies. Synovial fluid aspiration. Aspiration of cold abscess and AFB examination of pus. Histopathological examination of granulation tissue obtained by biopsy or curettage.

    Differential diagnosis
    In early stages presenting with synovitis, exclude...
    Subacute pyogenic infection Monoarticular rheumatoid arthritis Chronic traumatic synovitis Rheumatic arthritis Haemophilic arthritis

    Treatment
    Aim of treatment is to achieve a painless mobile joint. In late stages, some amount of pain and stiffness persists in spite of treatment. Modalities:

    CONSERVATIVE TREATMENT OPERATIVE TREATMENT

    Conservative treatment:
    ATT General care Local care of knee
    Knee rested by applying belowknee skin traction (or) aboveknee POP slab. Helps in healing process. Helps in associated muscle spasm that keeps knee deformed.

    Operative Treatment:
    Synovectomy:
    In cases of purely synovial tuberculosis.

    Joint debridement:
    In cases where articular cartilage is preserved.

    Arthrodesis:

    Charnleys compression arthodesis A popular method. In advanced stages with triple subluxation and complete cartilage destruction.

    the end

    You might also like