Tuberculosis of bone and joint is quite common in India. Spine is the most common involvement of musculoskeletal tuberculosis. Hip is the next most common joint.
Because of endemicity most of the diagnoses are made on basis of clinical examination and radiological appearance.
Tubercular Arthrits of Hip
In the image a lesion on femoral head and acetabulum is being seen. This kind of lesion is called “Kissing Lesion” [arrow]and is hallmark of infection.
Tuberculosis of hip joint if recognized in very early stage resolves completelt by antitubercular chemotherapy. The xray shows the diseas ein advanced stage where the joint has already been destroyed. In such cases a residual pain/deformity/dysfunction is left in spite of treatment.
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I advice operation debride the lision and hip fusion.
before operation, atit-TB medicine should be employed for 2-3 weeks and then clean the foci and fuse the hip with autograft.
maybe 2-3 years later, the fused hip could be converted to total hip replacement.
Dr Arun Pal Singh Reply:
September 15th, 2009 at 3:37 pm
@CHAO ZHANG,
Yes! that is one of the option. We also do THR in active TB. Provides more mobility.
sir,
shortly informative but you may add something more….thank you sir…..
respected sir, iam a 26 old male..working as a lab tech in KSA. I feel too much pain in my right hip joint , now it on my right leg also.. My CRP is 74 .0 and my ESR is 35 in 1st 1 hr ,and my Total count was 13,700 , my weight is 75 kg no any lose.. I can’t lift my right leg..
Sir, you have any solution for solve my problum ?
Dr Arun Pal Singh Reply:
October 2nd, 2010 at 4:19 pm
@arun,
Did you see a doctor. If not you must see one and get a diagnosis made.
Anybody who cannot examine you would not be able to help you.
Respected Sir,
hi my name is aruna. i am 25 yr old girl.las 18 months i was complted my hip join courses.tb medicine and akt but after 3 months i feel majer pain inside hip join .how is it possible in pain in hip. because of i was complated my couses.pls need u r help me. some fever come in evening time nothing any problem about cough.pls given question answer pls i am watiing again i am face this proble pls tell me?
Dr Arun Pal Singh Reply:
November 27th, 2010 at 11:22 am
@ARUNA POL,
It is good that you have completed the anti tubercular therapy. If you are having pain, please see an orthopedic surgeon, get an xray to see if there is any secondary arthritis.
All the best.
HI SIR,
THANKS FOR U R REPLAY . I AM VISITED IN KYN an orthopedic surgeon. JUST NOW I AM HAVING A 35 ESR AND HEMOGLOBIN 10.3 AND THEY GIVEN ME SOME MEDINCINE BUT TELL ME SOME WHICH TYPE CARE TO MY LEFT HIP JOIN FROM OUR SIDE.
Dr Arun Pal Singh Reply:
February 22nd, 2011 at 7:25 am
@ARUNA POL,
Please avoid using ALL CAPITAL LETTERS.
Did you ask your doctor about the care? What have you been told?
Dr. I just had a total hip replacement on the right, am due for a total on the left next year and now my knee may have to be replaced, all of this from arthrritus. I am only 46, and I am told to young for so much degeneration, my doctor found a substance he described in my joint during surgery as mushy, or oatmeal looking in texture, he has never seen this before and has sent off for analysis, one thing he is checking is tb of the bone. what I’m wondering is if you have ever heard of what I’ve described? Results are back in two weeks, but thought I’d ask around, thank you, Heidi
Dr Arun Pal Singh Reply:
October 14th, 2011 at 3:28 pm
@Heidi Thomas,
Sorry for the delay. it is not possible to tell anything from gross description alone. Only the results of histopathology are reliable.
What do they say?