CLINICAL PROFILE OF PATIENTS WITH MUSCULOSKELETAL TUBERCULOSIS VISITING A TERTIARY CARE CENTRE IN INDIA

Abstract

Background: Musculoskeletal tuberculosis a major cause of mortality and morbidity in India and other developing countries. Musculoskeletal TB comprises around 10 to 30% of all EPTB cases. Even though skeletal tuberculosis is an important debilitating disease, the literature in statistical data regarding the socio-demographic distribution and clinical presentation of disease is very scarce. Objective: To study the socio- demographic and clinical profile of musculoskeletal tuberculosis patients reaching the Orthopaedics Department in a tertiary care hospital in India. Methodology: 186 patients with musculoskeletal tuberculosis who have completed treatment were called for a follow up and data regarding demographic, person and illness related factors affecting disease were collected and were tabulated and represented in various charts and diagrams, and analysed. Results: Almost equal sex distribution was seen. Maximum proportion (26%) of the patients were belonging to 40-49 age group, with a mean age of 49.6 years. Patients with age <40 had less incidence compared to middle aged and elderly patients. Maximum number of patients were belonging to upper lower class (102 out of 186). Spine was the commonest site involved among the 138 cases. Spinal involvement was predominant in dorso- lumbar junction followed by thoracic spine and lumbar spine. 100% patients had pain as the presenting complaint and other complaints were not consistent. Only 16% of the patients had history of pulmonary tuberculosis and history of contact with tuberculosis case was present in 25% cases. 28% cases were diabetic and other comorbidities were less frequent. 19% of the cases had multi drug resistance. Conclusion: It was seen that Musculoskeletal tuberculosis is most frequently seen in middle age with majority of spine affected cases. The study reinforces the acquaintance of tuberculosis with low socioeconomic status and to some extend the debilitating diseases. It often has an atypical presentation leading to delay in diagnosis.