Tuberculous arthritis in childhood: a propos of one early-onset case

Abstract

Tuberculous arthritis is an infrequent condition, but no exceptional. It must be taken into account in differential diagnosis with all insidious onset arthritis. Diagnosis is based on a complete clinical history. Mantoux skin test is useful, mainly in children. It will be confirmed by direct identification and/or culture of M. tuberculosis from synovial fluid, and by identification of granulomas with central caseosis in synoyia. We report one 3 years 11 months old boy with tuberculous arthritis of the knee. It was precociously diagnosed for the knowledge of pulmonar tuberculosis in the family and a positive tuberculin test. There was no significant findings in roentgenographic examinations of chest and knee. The synovial fluid showed non-specific inflammatory modifications. A 3-drugs treatment was started, after this clinical suspicion. The evolution was favourable. The bacteriological confirmation on synovial fluid is not frequent in childhood, but it avoids the use of other more invasive techniques.