An Observational Study on Presentation, Diagnosis and Management of Cases of Osteoarticular Tuberculosis in North Indian Population

Abstract

 Introduction: Osteoarticular tuberculosis (OA TB), a form of extrapulmonary TB, predominantly affects bones and joints, with patients often experiencing significant pain and functional impairment. Aim and Objectives: This study examined the presentation, diagnosis, and management of OA TB at MMIMSR, Mullana, from April 2022 to September 2024. Materials and Methods: This study examined the presentation, diagnosis, and management of OA TB in 22 patients at MMIMSR, Mullana.The age distribution ranged from 10 to 65 years, with higher concentrations in middle-aged groups (25-30, 35-40 and 50-55 years), each accounting for approximately 14.29% of cases. Females represented 68.18% of the sample, indicating a higher prevalence among women. Results: The thoracic lumbar region was the most commonly affected area (31.82%), followed by the thoracic spine, hip, knee, and lumbar spine regions (13.64% each). The predominant symptom was pain (100%), with swelling (27.27%) and weight loss (22.73%) also reported. Most patients had no significant past TB history (81.82%), suggesting OA TB often presents as a primary infection. Diagnosis was primarily clinico-radiological (77.27%), with additional tools like CBNAAT, ZN stain, and histopathology used in complex cases. The duration of antitubercular therapy (ATT) varied, with the most common being 15 months (36.36%). However, adherence challenges were noted, with some patients lost to follow-up. Neurovascular deficits were present in 45.45% of patients, ranging from mild to severe motor weakness, predominantly affecting the lower limbs. Conclusion: This study underscores the importance of early detection, accurate diagnosis, and individualized treatment plans to improve patient outcomes in OA TB. Addressing diagnostic and treatment disparities globally, especially in high-burden regions, and enhancing patient adherence to therapy are crucial for effective TB management. The findings provide valuable insights into the epidemiology, clinical manifestations, and treatment outcomes of OATB, informing strategies to mitigate its impact on public health.