족부, 족관절 결핵
Tuberculosis in Foot and Ankle
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: To emphasize the importance of considering tuberculosis in atypical cases of foot and ankle by reporting clinical results of those cases. Materials and Methods: Seven cases which were diagnosed as tuberculosis around foot and ankle from March 1996 to June 2007 were included. We reviewed initial impressions, the time to be diagnosed, clinical symptoms, laboratory findings, radiological findings and the clinical results and complications. Results: We followed up at least 6 months (6~24 months) after surgery in all cases. Initially 2 cases had been diagnosed as cellulitis, 4 cases as chronic osteomyelitis, and 1 case as an ankle instability. Tuberculosis was diagnosed after biopsy in all cases. Mean duration of symptom was 15 months (6~36 months) except in infants. There were various radiologic manifestations such as osteopenia, bony erosion or destruction and cystic changes. Symptoms were relieved in all cases within 4 months with chemotherapy followed by surgical biopsy, except one ankle which had been misdiagnosed as ankle instability and joint destruction was developed after modified Bröstrom surgery. Conclusion: It is important to perform a surgical biopsy for diagnosis and proper management even with a faint suspicion on tuberculosis in foot and ankle. And in case of need, when surgical biopsy is performed, curettage procedure may help to improve clinical result.
Abstract
Purpose: To emphasize the importance of considering tuberculosis in atypical cases of foot and ankle by reporting clinical results of those cases. Materials and Methods: Seven cases which were diagnosed as tuberculosis around foot and ankle from March 1996 to June 2007 were included. We reviewed initial impressions, the time to be diagnosed, clinical symptoms, laboratory findings, radiological findings and the clinical results and complications. Results: We followed up at least 6 months (6~24 months) after surgery in all cases. Initially 2 cases had been diagnosed as cellulitis, 4 cases as chronic osteomyelitis, and 1 case as an ankle instability. Tuberculosis was diagnosed after biopsy in all cases. Mean duration of symptom was 15 months (6~36 months) except in infants. There were various radiologic manifestations such as osteopenia, bony erosion or destruction and cystic changes. Symptoms were relieved in all cases within 4 months with chemotherapy followed by surgical biopsy, except one ankle which had been misdiagnosed as ankle instability and joint destruction was developed after modified Bröstrom surgery. Conclusion: It is important to perform a surgical biopsy for diagnosis and proper management even with a faint suspicion on tuberculosis in foot and ankle. And in case of need, when surgical biopsy is performed, curettage procedure may help to improve clinical result.
참고문헌 (22)
- Allen AR, "A ten- year follow-up of combined drug therapy and early fusion in bone tuberculosis", J Bone Joint Surg, 49(A), pp.1001~1003 (1967)
- Allen AR, "The results of combined drug therapy and early fusion in bone tuberculosis", J Bone Joint Surg, 39(A), pp.32~42 (1957)
- Bozkurt M, "Isolated medial cuneiform tuberculosis : a case report", J Foot Ankle Surg, 44, pp.60~63 (2005)
- Campos OP, "Bone and joint tuberculosis and its treatment", J Bone Joint Surg, 37(A), pp.937~966 (1955)
- Dhillon MS, "Tuberculosis of bones and joints of the foot: an analysis of 22 cases", Foot Ankle, 14, pp.505~513 (1993)
- Enarson DA, "Bone and joint tuberculosis. A continuing problem", Can Med Assoc J, 120, pp.139~145 (1979)
- Harris RI, "Prognosis in bone and joint tuberculosis: an analysis of the results of treatment and a consideration of the factors which influence the end result", J Bone Joint Surg, 24(A), pp.382~395 (1942)
- Huang CH, "Extra-articular tuberculous osteomyelitis. A report of 11 cases", Int Orthop, 20, pp.169~171 (1996)
- Inoue S, "Ankle tuberculosis: a report of four case in a Japanese hospital", J Orthop Sci, 9, pp.392~398 (2004)
- Jerome JTJ, "Tuberculosis of the cuneiform", Foot Ankle Surg, 13, pp.199~202 (2007)
- Lafond EM, "An analysis of adult skeletal tuberculosis", J Bone Joint Surg, 40(A), pp.346~364 (1958)
- Lee HK, "clinical study on tuberculosis of the peripheral bone and joints of 198 cases", J Korean Orthop Assoc, 12, pp.361~366 (1977)
- Shembekar A, "Chemotherapy for osteoarticular tuberculosis", Clin Orthop Rela Res, 398, pp.20~26 (2002)
- Silva JF, "A review of patients with skeletal tuberculosis treated at the University Hospital, Kuala Lumpur", Int Orthop, 4, pp.79~82 (1980)
- Smith MHD, "Tuberculosis and opportunistic mycobacterial infections. Textbook of pediatric infectious disease", pp.1321~1362 (1992), Saunders
- Vallejo JG, "Tuberculous osteomyelitis of the long bones in children", Pediatr Infect Dis, 14, pp.524~546 (1995)
- Versfeld GA, "A diagnostic approach to tuberculosis of bones and joints", J Bone Joint Surg, 64(B), pp.446~449 (1982)
- Vohra R, "Saggar RR and Sharma R: Tuberculosis osteomyelitis", J Bone Joint Surg, 79(B), pp.562~566 (1997)
- Walker GF, "Failure of early recognition of skeletal tuberculosis", Br Med J, 1, pp.682~683 (1968)
- Watts HG, "tuberculosis of bones and joints", J Bone Joint Surg, 78(A), pp.288~299 (1996)
- Wilkinson MC, "Synovectomy and curettage in the treatment of tuberculosis of joints", J Bone Joint Surg, 35(B), pp.209~224 (1953)
- Yoon HS, "Clinical observation on tuberculosis of the bone and joint", J Korean Orhop Assoc, 19, pp.317~324 (1984)