1/5. Insidious destruction of the hip by mycobacterium tuberculosis and why early diagnosis is critical.Tuberculosis has re-emerged as an important problem in the united states. More than 10 million people presently are infected with mycobacterium tuberculosis in the united states alone. The symptoms at first presentation of the disease have become more diverse. With extrapulmonary manifestations, such as musculoskeletal infections, as the sole presenting sign, it often can be difficult to determine the correct diagnosis early in the course of the disease. The presenting symptoms, physical signs, and radiographic findings of intra-articular tuberculosis can mimic those of other intra-articular diseases, such as rheumatoid arthritis, osteoarthritis, and avascular necrosis. In view of the nonspecific findings early in course of the disease, tubercular infection should be considered in the differential diagnosis when there is insidious articular destruction. Failure to consider tuberculosis can lead to devastating outcomes otherwise preventable with today's chemotherapies.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/5. Physical therapist management of tuberculous arthritis of the elbow.BACKGROUND AND PURPOSE: Tuberculous arthritis is not commonly seen by physical therapists in the united states. The purpose of this case report is to describe a case of tuberculous arthritis of the elbow. CASE DESCRIPTION: The patient was a 36-year-old man referred for physical therapy evaluation and intervention for chronic elbow pain. After an evaluation and a trial of physical therapy, the patient was referred back to a primary care provider for additional tests to rule out systemic pathology. An open debridement of synovium and biopsy of the capitellum and radial head was positive for acid-fast bacilli, which was later identified as mycobacterium tuberculosis. OUTCOMES: The patient was placed on a 4-drug antituberculosis regimen that resolved all patient complaints and restored full elbow function. DISCUSSION: Tuberculous arthritis has characteristic findings during examination and in diagnostic tests. Although tuberculous arthritis is uncommon, it should be considered when patients have chronic or vague musculoskeletal complaints.- - - - - - - - - - ranking = 3keywords = physical (Clic here for more details about this article) |
3/5. Tuberculosis of the subdeltoid bursa. A case report.The 10th reported case of tuberculosis of the subdeltoid bursa is described. A 45-year-old Caucasian woman presented with a 30-year clinical history of subdeltoid bursitis, with typical physical signs, but with normal x-rays of the shoulder-joint region and lungs. The diagnosis was made by needle aspiration and was later confirmed by bacteriologic and histological examination of the surgical specimen. Following surgery and chemotherapy, the patient has remained free of any active tuberculosis disease for the past five years.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/5. Chronic sciatica caused by tuberculous sacroiliitis. A case report.STUDY DESIGN. This is a case report. OBJECTIVES. To report and discuss a case of tuberculosis sacroiliitis with anterior synovial cyst presenting as chronic sciatica. SUMMARY OF BACKGROUND DATA. This is a report of clinical manifestation, physical findings, computed tomography scan, and results after surgical treatment in a 58-year-old woman with tuberculous sacroiliitis, which caused chronic sciatica. methods. The physical findings, laboratory data, radiographs, and computed tomography scan of sacroiliac joints were studied. sacroiliitis with anterior synovial cyst was shown in computed tomography scan. Posterior arthrotomy and drainage of the synovial cyst were performed. After surgery, she was treated with three combined antituberculosis drugs for 9 months. RESULTS. Lowenstein-Jensen culture and histologic examination confirmed the diagnosis of tuberculous sacroiliitis. At 3 years, she had no back pain or sciatica and a complete functional recovery. CONCLUSIONS. Tuberculous sacroiliitis with anterior synovial cyst is a rare cause of chronic sciatica. Lateral compression of the pelvis, Gaenslen's test, and Patrick's test should be included in evaluation of patients with sciatica. Computed tomography scan is a superb diagnostic method for sacroiliitis. Arthrotomy and drainage effectively relieve the sciatica. Three combined antituberculosis drug therapy should be given after surgery.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
5/5. delayed diagnosis of tuberculosis presenting as small joint arthritis--a case report.Small joint arthritis is an uncommon manifestation of tuberculosis. We report a case of tuberculosis presenting as arthritis of the midtarsal joints with concomitant spinal involvement. This case illustrates the difficulties in diagnosing tuberculous arthritis as it has an insidious onset, paucity of constitutional symptoms, unremarkable early physical findings and frequent absence of associated pulmonary involvement. A high index of suspicion in high-risk individuals with chronic monoarthritis, is required to avoid delayed diagnosis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |