A18.02

Clinical Causes: Infection with Mycobacterium tuberculosis bacteria Spread from a primary tuberculosis site elsewhere in the body, such as the lungs Hematogenous dissemination, where bacteria travel via the bloodstream to the joint In cases of compromised immune systems, increasing susceptibility to TB spread Rarely, via direct extension from nearby infected tissue

Key Symptoms: Persistent joint pain, often worsening over weeks or months Swelling and tenderness around the affected joint Reduced joint mobility and stiffness Localized warmth over the joint Possible systemic symptoms such as fever, night sweats, and weight loss Gradual deterioration of joint function, potentially leading to deformity

Diagnosis Path: Medical history review, including potential TB exposure or previous infection Physical examination assessing joint swelling, tenderness, and range of motion Imaging studies such as X-rays, MRI, or ultrasound to evaluate joint damage and inflammation Laboratory tests including increased erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) Joint aspiration to obtain synovial fluid for microscopy, culture, and PCR testing for Mycobacterium tuberculosis Biopsy of joint tissue, if necessary, for histopathological examination

Treatment Protocols: Prolonged course of anti-tuberculosis medication, typically involving multiple drugs such as isoniazid, rifampicin, ethambutol, and pyrazinamide Duration of treatment often extends over 6 to 12 months, depending on the severity and response Resting the affected joint during the initial phases to reduce pain and prevent further damage Surgical interventions, such as joint debridement or drainage, may be necessary for abscesses or severe damage Physiotherapy to restore joint mobility and strength after initial treatment phases Monitoring for drug side effects and ensuring adherence to therapy