The Economic Burden of Femoral Neck Fractures in Jamaica.

Osteoporotic femoral neck fractures are increasing as the population ages. There is a significant cost to care for patients with such fractures. We prospectively analysed the in-hospital cost of managing 85 patients admitted to the University Hospital of the West Indies (UHWI) with such fractures. The majority of patients were females, 78.8%, and the mean age of the cohort was 83.7 years. There was a significant difference in the mean preoperative delay and length of stay between those patients treated publicly as compared to those treated privately, 9.6 vs 3.1 days and 18.9 vs 8.8 days, respectively. The mean acute cost of those treated publicly was 39% of the cost of those treated privately, J$110 878.80 vs J$284 287.61. The economic cost per year to the country for the acute management of femoral neck fractures was calculated at J$46 264 528.76 which is 0.30% of the 2005-2006 budgetary allocation for health. This cost was significantly associated with the length of hospital stay and the number of complications developed.

Extraspinal osteoarticular tuberculosis: a forgotten entity?

Tuberculosis affects a significant percentage of the world's population and is responsible for bone and joint infections particularly in the developing world. The problem has been compounded by the HIV/ AIDS epidemic. Whereas tuberculous involvement of the spine is readily included in a list of differentials for destructive lesions of the spine, infection in other skeletal areas is often not considered. In endemic areas, physicians are aware of the clinical and radiological presentations of musculoskeletal tuberculosis. In non-endemic areas, this knowledge is often lacking. Diagnostic delay often results in increased morbidity and mortality. There is a need therefore to highlight extra-spinal osteoarticular tuberculosis as a real entity.

Extraspinal osteoarticular tuberculosis: a forgotten entity? / La Tuberculosis Osteoarticular Extraespinal ¿Una Entidad Olvidada?

Tuberculosis affects a significant percentage of the world's population and is responsible for bone and joint infections particularly in the developing world. The problem has been compounded by the HIV/ AIDS epidemic. Whereas tuberculous involvement of the spine is readily included in a list of differentials for destructive lesions of the spine, infection in other skeletal areas is often not considered. In endemic areas, physicians are aware of the clinical and radiological presentations of musculoskeletal tuberculosis. In non-endemic areas, this knowledge is often lacking. Diagnostic delay often results in increased morbidity and mortality. There is a need therefore to highlight extra-spinal osteoarticular tuberculosis as a real entity

La tuberculosis afecta a un porcentaje significativo de la población mundial, y es causa de infecciones en los huesos y las articulaciones, particularmente en los países en vías de desarrollo. El problema ha sido agravado por la epidemia del HIV/AIDS. Mientras que la tuberculosis vertebral suele incluirse con prontitud en la lista de diagnósticos diferenciales de las lesiones destructivas de la columna vertebral, la infección en otras áreas de la estructura ósea a menudo se pasa por alto. En las regiones endémicas, los médicos conocen las manifestaciones clínicas y radiológicas de la tuberculosis músculoesqueletal. En las regiones no endémicas, este conocimiento está a menudo ausente. Con frecuencia, la demora en el diagnóstico trae como consecuencia una mayor morbosidad y mortalidad. Por lo tanto, se hace necesario prestar atención a la tuberculosis osteoarticular extraespinal como una entidad real