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Musculoskeletal Tuberculosis in Children

Volume 9 | Issue 3 | September-December 2023 | Page: 28-34 | Santoshini Nemuri, Mandar Agashe DOI- https://doi.org/10.13107/ijpo.2023.v09.i03.160 Authors: Santoshini Nemuri MS Ortho [1], Mandar Agashe MS Ortho [1] [1] Department of Orthopaedics, Agashe Paediatric SuperSpeciality Clinic, Mumbai, Maharashtra, India. Address of Correspondence Dr. Mandar Agashe Chief consultant, Department of Orthopaedics, Agashe Paediatric SuperSpeciality Clinic, […]

Introduction to Paediatric Musculoskeletal Infections -A Review Article

Volume 9 | Issue 3 | September-December 2023 | Page: 02-08 | Suresh Chand, Bhushan Sagade, Udit Agarwal, Nishant Jagdale, Smit Rajput DOI- https://doi.org/10.13107/ijpo.2023.v09.i03.156 Authors: Suresh Chand MS Ortho [1], Bhushan Sagade MS Ortho [2], Udit Agarwal MS Ortho [1], Nishant Jagdale DNB Ortho [2], Smit Rajput MD [3] [1] Department of Paediatric Orthopaedics, King […]

Musculoskeletal Tuberculosis in Children

Introduction to Paediatric Musculoskeletal Infections -A Review Article

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Musculoskeletal Tuberculosis in Children

Volume 9 | Issue 3 | September-December 2023 | Page: 28-34 | Santoshini Nemuri, Mandar Agashe

DOI- https://doi.org/10.13107/ijpo.2023.v09.i03.160

Authors: Santoshini Nemuri MS Ortho [1], Mandar Agashe MS Ortho [1]

[1] Department of Orthopaedics, Agashe Paediatric SuperSpeciality Clinic, Mumbai, Maharashtra, India.

Address of Correspondence

Dr. Mandar Agashe
Chief consultant, Department of Orthopaedics, Agashe Paediatric SuperSpeciality Clinic, Mumbai, Maharashtra, India.
E-mail: mandarortho@gmail.com

Abstract

Paediatric musculoskeletal tuberculosis is very important to understand as it shares similar clinical, radiological and hematologocal findings with other infectious and non-infectitious conditions . It has become a major health hazard because of its association with immunocompromised states like HIV, Diabetes mellitus and chronic renal and liver diseases. Diagnosis is delayed in paediatric musculoskeletal tuberculosis because of lack of awareness of disease , non-specific clinical and laboratory findings. TB culture is considered as the gold standard in diagnosing tuberculosis and also, detecting drug sensitivity. Because of its potential for multi-drug resistance, there is a dilemma regarding drug of choice and duration of treatment. Surgery is reserved for obtaining samples to establish diagnosis, debridement and sequestrectomy in recalcitrant infections and correction of deformities to restore joint function. This review article briefs about classical clinical presentation, atypical and multifocal musculoskeletal tuberculosis, radiological and laboratory investigations and management of paediatric musculoskeletal tuberculosis.
Musculoskeletal tuberculosis should be kept as a differential diagnosis when managing a case of musculoskeletal infection in children because of its non- specific presentation. Imaging such as MRI and advanced microbiological analysis aids in arriving correct diagnosis. Multidrug chemotherapy is mainstay of treatment. Radical curettage and, antituberculous chemotherapy followed by a period of immobilisation and rehabilitation will give excellent results
Keywords: Paediatric musculoskeletal tuberculosis, multifocal tuberculosis, Tubercular osteomyelitis

References

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How to Cite this Article: Nemuri S, Agashe M | Musculoskeletal Tuberculosis in Children | International Journal of Paediatric Orthopaedics | September-December 2023; 9(3): 28-34.| https://doi.org/10.13107/ijpo.2023.v09.i03.160

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Introduction to Paediatric Musculoskeletal Infections -A Review Article

Volume 9 | Issue 3 | September-December 2023 | Page: 02-08 | Suresh Chand, Bhushan Sagade, Udit Agarwal, Nishant Jagdale, Smit Rajput

DOI- https://doi.org/10.13107/ijpo.2023.v09.i03.156

Authors: Suresh Chand MS Ortho [1], Bhushan Sagade MS Ortho [2], Udit Agarwal MS Ortho [1], Nishant Jagdale DNB Ortho [2], Smit Rajput MD [3]

[1] Department of Paediatric Orthopaedics, King George’s Medical University, Lucknow, India.
[2] Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Mumbai, India.
[3] Department of Internal Medicine, East Carolina University and ECU Health Medical Center, Greenville, North Carolina, USA.

Address of Correspondence

Dr. Nishant Jagdale,
Fellow in Paediatric Orthopaedics, Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Mumbai, India.
E-mail: nishant93ortho@gmail.com

Abstract

Paediatric Musculoskeletal Infections include osteomyelitis, septic arthritis, pyomyositis, surgical site infections, tuberculosis, and fungal infections with some infrequent manifestations like purpura fulminans, necrotizing fasciitis, soft tissue abscess and septic bursitis. Osteomyelitis and septic arthritis are two common Musculoskeletal Infections. Vertebral tuberculosis is the most common form of skeletal tuberculosis. Staphylococcus aureus is the most frequent cause of Paediatric Musculoskeletal Infections, followed by streptococci. They can be classified on the basis of pathogen, anatomical site, spread, severity etc. Pathogenic organisms may reach a bone or soft tissue location by either of the three means: (a) direct inoculation from penetrating trauma or surgery, (b) contiguous spread from an adjacent soft tissue infection, (c) hematogenous spread from a distant focus of infection with hematogenous spread being the most common cause. It is a complex interplay between the host and the pathogen which plays major role in these infections. Peculiar anatomy of the metaphysis with classical hairpin loop system of the end arterioles and venous sinusoids aids in pathogen entry into the host. After successful invasion of the host, bacteria escapes the host immunity through various mechanisms, complement component pathway being the most common way. Also the various toxins and proteins secreted by bacteria plays an important role in adhesion, invasion, escape form immunity and spread of the infection. This review article helps in understanding this complex interplay between host and pathogen which ultimately results in infection

Keywords: Paediatric Musculoskeletal infections, Osteomyelitis, Pyomyositis, Septic Arthritis.

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How to Cite this Article: Chand S, Sagade B, Agarwa U, Jagdale N, Rajput S | Introduction to Paediatric Musculoskeletal Infections- A Review Article | International Journal of Paediatric Orthopaedics | September- December 2023; 9(3): 02-08.| https://doi.org/10.13107/ijpo.2023.v09.i03.156

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Musculoskeletal Tuberculosis in Children

Introduction to Paediatric Musculoskeletal Infections -A Review Article

Musculoskeletal Tuberculosis in Children

Introduction to Paediatric Musculoskeletal Infections -A Review Article

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Musculoskeletal Tuberculosis in Children

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Introduction to Paediatric Musculoskeletal Infections -A Review Article

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