A retrospective study of drug resistant osteoarticular tuberculosis

Introduction: Osteoarticuar tuberculosis comprises 1-4.3% of all tuberculosis cases and 10-15% of all extra pulmonary tuberculosis cases.The diagnosis of osteoarticular tuberculosis is mainly clinico-radiological and presents a greater diagnostic challenge due to less liberation of bacilli.Drug resistant form of osteoarticular tuberculosis has very rare prevalence and less commonly studied. This study presents a series of drug resistant osteoarticular TB cases, their clinic-radiological as well as drug resistence profile. Material methods: This was a retrospective study in patients attending outpatient/in patient department at P. D. Hinduja National Hospital Mumbai between August 2005-2014. Total 25 patients were included.Data retrieval system of the institute was used to retrieve the demographic and clinical data of the patients diagnosed to have tuberculosis. All patients were subjected to telephonic interview including answers to a set of questionnaire. Collected data was analyzed statistically. Results: In our study the average age of patients having drug resistant osteoarticular tuberculosis was 24.92 years. Drug resistant tuberculosis of spine was seen in 21.62% cases, calcaneum osteomyelitis in 10.81% cases and SI joint, foot, tibia, ankle joint were involved in 8.11% cases each.total 37 different sites of osteoarticular system involved and multifocal tuberculosis (>1 bone involved) was seen in 7 patients (28%), Single bone involved in 18 patients (72%).18 patients were MDR strains (72%), 1 had XDR strain (4%) and 5 patients had monoresistance (20%) and 1 patient was resistant to 2 drug (non MDR) (4%). Conclusion: This study highlights the growing threat posed by the development of resistance to antituberculous drugs in the management of osteoarticular tuberculosis. Delay in diagnosis of drug resistance can lead to further complications and non response to standard antitubercular treatment.