Poncet's Disease Research Articles

Poncet's disease—a novel cause of non-compliance with anti-tuberculous drugs

We present a patient with isoniazid resistant pulmonary tuberculosis (Tb) associated with large joint polyarthropathy. A diagnosis of Poncet’s disease (PD) was made. This case highlights the problems of non-compliance with drug therapy, directly observed therapy (DOT) and difficulty in diagnosing PD. The mechanisms for PD are discussed and the links between mycobacterial infection and rheumatoid arthritis (Rh.A) are reviewed.

Post-infective Arthritis

<h2>Abstract</h2> Arthritis that follows an identifiable infection but does not have the characteristics of joint sepsis may be considered post-infective. Thus, reactive arthritis, rheumatic fever and meningococcal arthritis fall within this broad group of diagnoses. Such conditions are distinct from arthritis that occurs during dissemination of bacterial or viral infections; this may more properly be described as infective. In some forms of arthritis following infection (e.g. Lyme disease, Whipple's disease, Poncet's disease), very small numbers of viable micro-organisms are found in the joint and the arthritis improves with antibiotic treatment. These conditions are therefore better considered as low-grade septic arthritis, though the mechanisms underlying any chronicity are ill understood. The detection (using polymerase chain reaction analysis) of minute numbers of bacteria in joint samples from a wide variety of forms of arthritis formerly considered aseptic has emphasized the fact that distinction between septic, post-infective and non-infective arthritis remains unclear. It may be pragmatic to consider these conditions as a spectrum of infection-related arthritis, from frank septic arthritis to truly sterile arthritis. This contribution considers reactive arthritis (Reiter's syndrome), rheumatic fever, and other forms of post-infective arthritis in which no viable infective agents can be cultured from the joints and no response to antibiotic therapy is seen.

Multifocal Tubercular Dactylitis in an Adult

Musculoskeletal tuberculosis (TB) is a rare manifestation of TB comprising 1%-3% of all cases. We describe a patient who had multiple manifestations of skeletal TB, including spondylitis, dactylitis, and Poncet's disease. The unusual features include multifocal dactylitis, widespread disease in the absence of any risk factor like HIV infection or immunosuppressive treatment, and absence of pulmonary lesion. Treatment with appropriate drugs, using 4 agents for the first 2 months, led to complete recovery. TB can rarely present in an unusual way but is very important to recognize, as with treatment it still carries a good prognosis.

Poncet's disease in a north Indian hospital.

Although the entity of tuberculous rheumatism or Poncet's disease has sometimes been the subject of debate, it has been reported infrequently in the English literature. We discuss here seven patients (5 women, 2 men; age 18-48 years) who presented primarily with polyarthritis and fever and developed pulmonary, pleural or nodal tuberculosis later in the course of disease. Rheumatoid arthritis, collagen vascular diseases and other common causes of polyarthritis were ruled out by appropriate investigations. Polyarthritis resolved in all the patients after the institution of antitubercular treatment and did not recur, thus providing a therapeutic confirmation of the clinical diagnosis.

Poncet's disease and papulonecrotic tuberculid in a patient infected with the human immunodeficiency virus

We report the case of a 27-year-old patient with the human immunodeficiency virus (HIV) infection who presented with a 2-week history of crops of painful, red papules over the trunk and extremities, together with a sterile, symmetric polyarthritis involving the small and large joints. Histologic study of a skin biopsy specimen demonstrated features of papulonecrotic tuberculid. Analytical and microbiologic studies ruled out tuberculous infection. Both the synovial and the skin processes were considered to be an immune response secondary to Mycobacterium tuberculosis infection. Specific treatment was established, and there was marked improvement in both the skin and joint symptoms. This case illustrates the complex relationship between the host and the HIV, suggesting an immune dysregulation cause for both the synovial and the skin lesions.

Reactive arthritis after mycobacterium avium-intracellulare infection: Poncet's disease revisited

Reactive arthritis after mycobacterium avium-intracellulare infection: Poncet's disease revisited

CHRONIC TUBERCULOUS RHEUMATISM (PONCET'S DISEASE) IN A GYMNAST

Chronic arthritis, whether primary or reactive, is an unusual manifestation of long standing tuberculosis. We described the case of a 16-year-old gymnast with tuberculous rheumatism (Poncet's disease) secondary to Pott's disease of the dorsal spine. The possible pathogenetic mechanisms are discussed.

The Molecular Basis of Poncet's Disease?

The Molecular Basis of Poncet's Disease?

Two cases of Poncet's disease

Poncet's disease is a rare polyarthritis occurring in patients with tuberculous infections. We describe two cases of polyarthritis, one secondary to pulmonary tuberculosis, the other secondary to tuberculous infection of the elbow joint. In both cases the arthritis rapidly subsided with chemotherapy.

Poncet's disease: para-infective tuberculous polyarthropathy.

Poncet's disease: para-infective tuberculous polyarthropathy.

Poncet's disease — fact or fiction? A re-appraisal of tuberculous rheumatism

Tuberculous rheumatism is not generally accepted as a specific disease entity in Great Britain or the U.S.A. Evidence is presented to re-open the controversy surrounding its existence, with a report of 2 new cases, and a review of the literature.

Poncet's disease; clinical observations on inflammatory and degenerative joint reactions in tuberculosis.

Poncet's disease; clinical observations on inflammatory and degenerative joint reactions in tuberculosis.