Die Schambeintuberkulose und ihre Differentialdiagnose

Abstract

Tuberculous foci in the pubic bone or in the region of the pubic symphysis, are rare. During the past 25 years (1955 - 1980) 9 patients have been surgically treated in our clinic (5 females and 4 male) with specific infections in this region (surgical treatment in conjunction with administration of tuberculostatics). Diagnosis was established, with the exception of one patient, by bacteriological or histological examination of the focal material. The youngest patients was 17 years old, whereas the oldest was 62 (mean age 40.3 years). The average time which elapsed from the onset of the complaints to clarification of the diagnosis was 1.3 years. Four patients had already experienced pulmonary or extrapulmonary tuberculosis at an earlier date, and three patients had a concomitant specific infection of different localisation. Although - with the exception of one patient - all cases were late cases (abscesses, fistulas), the one-hour values of the BSR were within the normal range in more than half of the patients. In all patients, the tuberculous process had already spread to the symphysis and had produced a marked widening of the pubic symphysis. We did not observe further extension into the hip joint, the ischium, the obturator or the pelvic organs. We also did not observe any reactivations of the process in the 7 patients followed up by us after an average period of 4 years subsequent to their discharge from hospital.