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1.
Curr Health Sci J ; 43(2): 153-158, 2017.
Article in English | MEDLINE | ID: mdl-30595871

ABSTRACT

Osteoarticular tuberculosis (OATB) is a secondary chronic infection with paubacillary bacillus Koch (BK) that has bone and joint interest. Today in Romania, tuberculosis is a primary public health problem, according to World Health Organization (WHO) in 2015 alone, there have been 10.4 million new cases of tuberculosis (TB) in the world, of which 15.195 in Romania. Pulmonary and extrapulmonary tuberculosis, especially the osteoarticular form, with multiple outbreaks should of had a minimal impact, but because of the multiple characteristics such as: epidemiological, geographic, associated diseases, diagnosis capacity, therapeutic options, gene pool and racial evolutiv traits, the disease spreading and management in both developed and underdeveloped countries, the TB infection has seen an increase in the number of cases (e.g. Africa and Asia). Today there is a fecundity upsurge of BK infection, especially pronounced in low income populations, country side people being the most affected. There are multiple breakthroughs in the understanding of Mycobacterium tuberculosis physiopathology. This fact offers us a modern and genetically guided approach in the diagnosis, evolutive patterns and treatment involving the OATB.

2.
Curr Health Sci J ; 43(3): 171-190, 2017.
Article in English | MEDLINE | ID: mdl-30595874

ABSTRACT

Osteoarticular tuberculosis (OATB) is a rare form of tuberculosis (TB) whose incidence rose significantly nowadays especially in the underdeveloped countries. The main risk factors predisposing to this new challenge for the medical system are the Human Immunodeficiency Virus (HIV) epidemic, the migration from TB endemic areas and the development of drug and multidrug-resistant strains of Mycobacterium tuberculosis (Mt). The disease affects both genders and any age group although the distribution depending on gender is controversial and that depending on age has a bimodal pattern. In most cases the initial focus is elsewhere in the organism and the most frequent pathway of dissemination is lympho-haematogenous. The clinical picture includes local symptoms as pain, tenderness and limitation of motion, with some particularities depending on the segment of the osteoarticular system involved, sometimes accompanying systemic symptoms specific for TB and other specific clinical signs as cold abscesses and sinuses. The radiographic features are not specific, CT demonstrates abnormalities earlier than plain radiography and MRI is superior to plain radiographs in showing the extent of extraskeletal involvement. Both CT and MRI can be used in patient follow-up to evaluate responses to therapy. TBhas been reported in all bones of the body, the various sites including the spine (most often involved) and extraspinal sites (arthritis, osteomyelitis and tenosynovitis and bursitis). Two basic types of disease patterns could be present: the granular type (most often in adults) and the caseous exudative type (most often in children) one of which being predominant. The algorithm of diagnosis includes several steps of which detection of Mt is the gold standard. The actual treatment is primarily medical, consisting of antituberculosis chemotherapy (ATT), surgical interventions being warranted only for selected cases. It is essential that clinicians know and refresh their knowledge about manifestations of OATB.

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