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Tuberculosis of the Skeletal System
SM Tuli
SECTION 1: GENERAL CONSIDERATIONS
CHAPTER 1:
Epidemiology and Prevalence
CHAPTER 2:
Pathology and Pathogenesis
CHAPTER 3:
The Organism and Its Sensitivity
CHAPTER 4:
Evolution of Treatment of Skeletal Tuberculosis
PRE-ANTITUBERCULAR ERA
Pre-antitubercular Conservative Treatment
Orthodox Treatment (Bick 1976)
Natural Course of Skeletal Tuberculosis without Chemotherapy
Results of Orthodox Conservative Treatment
Prechemotherapy Operative Treatment and its Results
POST-ANTITUBERCULAR ERA
Sinuses and Ulcers
Relapse of the Disease or Recurrence
CHAPTER 5:
Diagnosis and Investigations
GENERAL CLINICAL PICTURE
DIAGNOSIS
Roentgenogram
Blood
Mantoux (Heaf) Test
Biopsy
Guinea Pig Inoculation
Smear and Culture
Isotope Scintigraphy
Serological Investigations
Modern Imaging Techniques
Poncet's Disease or Tubercular Rheumatism
CHAPTER 6:
Antitubercular Drugs
PAS
Isoniazid (INH)
Thioacetazone with other Drugs
Ethambutol
Rifampicin
Pyrazinamide
Alternative Regimens
Corticosteroids and Nonsteroidal Anti-inflammatory Drugs
THE ROLE OF ANTITUBERCULAR DRUGS
PENETRATION OF ANTITUBERCULAR DRUGS
CHAPTER 7:
Principles of Management of Osteoarticular Tuberculosis
PROGNOSIS AND COURSE
CLASSIFICATION OF ARTICULAR TUBERCULOSIS
Stage I: Synovitis
Stage II: Early Arthritis
Stage III: Advanced Arthritis
Stage IV: Advanced Arthritis with Subluxation or Dislocation
Stage V: Terminal or Aftermath of Arthritis
PRINCIPLES OF MANAGEMENT
General
Rest, Mobilization and Brace
Abscess, Effusion and Sinuses
Antitubercular Drugs (See Chapter 6)
Relapse of Osteo-articular Tuberculosis or Recurrence of Complications
Surgery in Tuberculosis of Bones and Joints
Extent and Type of Surgery
Healing of Disease
SECTION II: EXTRA-SPINAL REGIONAL TUBERCULOSIS
CHAPTER 8:
Tuberculosis of the Hip Joint
CLINICAL FEATURES
Tubercular Synovitis (Stage I)
Early Arthritis (Stage II)
Advanced Arthritis (Stage III)
Advanced Arthritis with Subluxation or Dislocation (Stage IV)
Classification of the Radiological Appearance
PROGNOSIS
MANAGEMENT
Management in Children
INDICATIONS FOR SURGICAL TREATMENT
Osteotomy
Arthrodesis
Excisional Arthroplasty
Stage of Disease and Operative Procedure
SURGICAL APPROACHES TO THE HIP JOINT
Transverse Anterior Approach to the Hip Joint
ALTERNATIVE APPROACHES
Synovectomy
Joint Debridement or Joint Clearance
Arthrodesis
Operative Technique of Intra-articular Arthrodesis
Abbott-Lucas' Technique of Fusion of Hip Joint in Two Stages
Brittain's Technique of Extra-articular Fusion of Hip Joint
Excision Arthroplasty of Hip Joint
Instability in Excision Arthroplasty
Replacement Arthroplasty
RELEVANT SURGICAL ANATOMY OF THE HIP JOINT
Immediate Relations of the Hip Joint
CHAPTER 9:
Tuberculosis of the Knee Joint
PATHOLOGY
CLINICAL FEATURES
DIFFERENTIAL DIAGNOSIS
PROGNOSIS
TREATMENT
Operative Treatment
SURGICAL TECHNIQUES
Synovectomy of Knee Joint
Synovectomy with Debridement (Joint Clearance)
Postoperative Regimen for Synovectomy with or without Debridement
Arthrodesis of the Knee Joint
Arthroplasty for Tuberculous Arthritis
Relevant Surgical Anatomy of Knee Joint
CHAPTER 10:
Tuberculosis of the Ankle and Foot
TUBERCULOSIS OF ANKLE
Clinical Features
Management
Operative Treatment
SURGICAL TECHNIQUE
TUBERCULOSIS OF FOOT
Relevant Surgical Anatomy of Ankle and Foot
CHAPTER 11:
Tuberculosis of the Shoulder
MANAGEMENT
ARTHRODESIS OF SHOULDER
Extra-articular Arthrodesis
Intra-articular Arthrodesis
OPERATIVE TECHNIQUE
RELEVANT SURGICAL ANATOMY OF THE SHOULDER JOINT
CHAPTER 12:
Tuberculosis of the Elbow Joint
MANAGEMENT
Role of Operative Treatment
OPERATIVE TECHNIQUES FOR TUBERCULOUS ELBOW
Excisional Arthroplasty
Arthrodesis
Relevant Surgical Anatomy of Elbow Joint
CHAPTER 13:
Tuberculosis of the Wrist
CLINICAL FEATURES
Management
Operative Treatment
Wrist Arthrodesis
Relevant Surgical Anatomy
CHAPTER 14:
Tuberculosis of Short Tubular Bones
DIFFERENTIAL DIAGNOSIS
TUBERCULOSIS OF THE JOINTS OF FINGERS AND TOES
CHAPTER 15:
Tuberculosis of the Sacroiliac Joints
CLINICAL FEATURES
MANAGEMENT
Operative Debridement and Arthrodesis
CHAPTER 16:
Tuberculosis of Rare Sites, Girdle and Flat Bones
CHAPTER 17:
Tuberculous Osteomyelitis
TREATMENT
CHAPTER 18:
Tuberculosis of Tendon Sheaths and Bursae
SECTION III: TUBERCULOSIS OF THE SPINE
CHAPTER 19:
Clinical Features
CHAPTER 20:
X-ray Appearances and Findings on Modern Imaging
CHAPTER 21:
Differential Diagnosis
PYOGENIC INFECTIONS
Typhoid Spine
Brucella Spondylitis
Mycotic Spondylitis
Syphilitic Infection of the Spine
Tumorous Conditions
Primary Malignant Tumor
Multiple Myeloma
Lymphomas
Secondary Neoplastic Deposits
Histiocytosis-X
Local Developmental Abnormalities of the Spine
Spinal Osteochondrosis
Traumatic Conditions
Osteoporotic Conditions
Spondylolisthesis
Hydatid Disease
CHAPTER 22:
Neurological Complications
CHAPTER 23:
Management and Results
EVOLUTION OF TREATMENT
Pre-antitubercular Era
Results of Operations on the Diseased Vertebrae in the Pre-antitubercular Era
Direct Operative Treatment with Antitubercular Drugs
Role of Direct Surgery in the Management of Spinal Tuberculosis
Role of Surgery in Neural Complications
Our Policy of Treatment (“Middle Path Regime”)
Operative Procedures done by us
Recrudescence of the Disease
Results of Management by Following the Middle Path
Palpable or Peripheral Cold Abscesses
Deep-seated Radiological Perivertebral Abscesses
Neurological Complications
Onset and Speed of Neural Recovery after Operation
Plantar Response
Recurrence or Relapse of Neural Complications
Fate of Disc Space and Radiological Healing
Radiological Healing of Vertebral Tuberculosis without Operation
Radiological Healing of Vertebral Tuberculosis with Operation on the Diseased Vertebral Bodies without Bone Grafting
Radiological Healing of Vertebral Lesion
Course of Kyphosis of Spine in Patients not Operated Upon
Course of Kyphosis of Spine in Lesions Operated Upon without Bone Grafting
Clinical Healing in Cases without Neurological Complications
Relapse or Recurrence or Complication
Tuberculosis of the Cervical Spine
Tuberculosis of the Craniovertebral Region
CHAPTER 24:
Operative Treatment
CHAPTER 25:
Spinal Braces
CHAPTER 26:
Relevant Surgical Anatomy
BIBLIOGRAPHY AND FURTHER READING
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INDEX
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