Ruiz-Osuna César, González-Colunga Ricardo
Hospital General de Morelia Dr. Miguel Silva.
Acta Ortop Mex. 2008 Jul-Aug;22(4):254-8.
Osteoarticular tuberculosis is a chronic inflammatory disease caused by Mycobacterium tuberculosis that affects joints. It reaches skeleton and joints by hematogenous spread. The clinical presentation includes localized pain associated with fever and weight loss. A cold abscess (swelling without inflammation) is strongly suggestive of musculoskeletal tuberculosis. Diagnosis requires a high degree of clinical suspicion, supported with radiological and laboratory techniques. Treatment requires thorough debridement of the joint and antitubercular medical treatment (isoniazid, rifampin, pyrazinamide, ethambutol, and streptomycin). We report a case of hip tuberculosis treated with resection arthroplasty, presenting as caseating abscess and severe destruction of the hip joint.
骨关节结核是一种由结核分枝杆菌引起的影响关节的慢性炎症性疾病。它通过血行播散累及骨骼和关节。临床表现包括伴有发热和体重减轻的局部疼痛。寒性脓肿（无炎症的肿胀）强烈提示肌肉骨骼结核。诊断需要高度的临床怀疑，并辅以放射学和实验室检查技术。治疗需要对关节进行彻底清创和抗结核药物治疗（异烟肼、利福平、吡嗪酰胺、乙胺丁醇和链霉素）。我们报告一例采用关节切除成形术治疗的髋关节结核病例，表现为干酪样脓肿和髋关节严重破坏。
