Tuberculosis arthritis of the elbow, a diagnostic problem

ABSTRACT

Recently, there has been an epidemic of tuberculosis, with increasing incidence of infected persons in UK. In the past 20 years, with the pandemic of the human immunodeficiency virus and the increase in immunocompromised people, we have observed a resurgence of tuberculosis. Tuberculosis arthritis of the elbow joint is not commonly seen by orthopaedic surgeons. Spinal and monoarthritis of weight-bearing joints such as the hip or knee are most frequently involved. The aim of this case report is to describe a rare case of occult tuberculous arthritis of the elbow in young Indonesian lady and the diagnostic problems that may arise and lead to a delay in treatmen. It is a case report where we used different laboratory test as CBC, ESR, CRP, hepatitis screening and AIDS Antibody test to help in diagnosis.Plain X-ray for elbow and chest used. CT scan for elbow, aspiration of synovial fluid for culture and synovial biopsy taken. Tuberculous arthritis remains low on the index of suspicion of many clinicians working outside the field of respiratory or infection diseases3 Involvement of the skeletal system is relatively rare. Musculoskeletal TB is responsible for between 1.3% and 5% of all cases of TB. Osteoarticular TB should be suspected in patients of south Asian and African origin presenting with bony and soft tissue infective lesions