Talbot J C, Bismil Q, Saralaya D, Newton D A G, Frizzel R M, Shaw D L
Department of Trauma and Orthopaedics, Bradford Teaching Hospitals NHS Trust, Bradford UK.
Ann R Coll Surg Engl. 2007 May;89(4):405-9. doi: 10.1308/003588407X183328.
Tuberculosis (TB) remains the most common cause of death from infectious disease world-wide. In the UK, the incidence of TB has risen by 25% over the last 10 years; extrapulmonary diagnosis remains challenging and can be delayed. This study evaluates the epidemiology of musculoskeletal tuberculosis in a large multi-ethnic UK city.
A review of prospectively recorded data of incidence, anatomical site, ethnic distribution, treatment and drug resistance of musculoskeletal tuberculosis over a 6-year period was performed.
From January 1999 to December 2004, there were 729 TB notifications; 61 cases (8.4%) had musculoskeletal involvement. Of the patients, 74% were immigrants from the Indian subcontinent; nearly 50% had spinal involvement; 24 patients underwent surgical intervention; 29 were subjected to either diagnostic or therapeutic radiological intervention; and resolution of symptoms was achieved in 59 out of 61 cases.
This study highlights the high proportion of musculoskeletal TB in immigrant patients in an area with a relatively large at-risk population, but will also serve to alert physicians, in areas with smaller at-risk populations, of the possibility of musculoskeletal TB.
结核病仍然是全球传染病致死的最常见原因。在英国,结核病发病率在过去10年中上升了25%;肺外结核病的诊断仍然具有挑战性,且可能会延迟。本研究评估了英国一个多民族大城市中肌肉骨骼结核的流行病学情况。
对前瞻性记录的6年间肌肉骨骼结核的发病率、解剖部位、种族分布、治疗及耐药性数据进行了回顾。
1999年1月至2004年12月期间,共报告了729例结核病;其中61例(8.4%)有肌肉骨骼受累。患者中,74%为来自印度次大陆的移民;近50%有脊柱受累;24例患者接受了手术干预;29例接受了诊断性或治疗性放射学干预;61例中有59例症状得到缓解。
本研究凸显了在一个高危人群相对较多的地区,移民患者中肌肉骨骼结核的比例较高,但同时也会提醒高危人群较少地区的医生注意肌肉骨骼结核的可能性。