원저 : 말초 결핵성 관절염

Objective: We evaluated the clinical characteristics of tuberculous arthritis in peripheral joints and their relationship with rheumatologic disorders or other chronic illnesses. Methods: One hundred and sixty seven patients who had suffered from skeletal tuberculosis were treated at Hanyang university medical center from January 1993 to December 2000. We retrospectively analyzed 39 patients who were diagnosed as tuberculous arthritis in peripheral joints. Results: Thirty-nine (21 males, 18 females) patients with tuberculous arthritis in peripheral joints, aged 38.13±15.28, were found. All except one had a mono-articular feature. Affected joints were knee in 22 (56.4%), hip in 7 (17.9%), and wrist in 3 (7.7%). Extra-articular tuberculosis was noticed in 18 (46.2%) patients: lung involvement in 13 (33.3%), spine involvement in 4 (10.3%) and epididymis involvement in 1 (2.6%). One or more predisposing factors were found in 13 (33.3%) patients: 10 patients had a previous trauma history and 3 patients with previous intra-articular injections. Predisposing systemic conditions were present in 12 (30.8%) patients: 4 rheumatoid arthritis, 2 systemic lupus erythematosus, 1 juvenile rheumatoid arthritis, 4 liver cirrhosis, 2 breast cancer and 1 diabetes mellitus. Conclusion: Tuberculous arthritis in peripheral joints were evident in weight bearing joints, such as knee and hip, and were frequently associated with predisposing local or systemic factors. It is most important for the physician to make an early diagnosis and perform adequate treatments to prevent further complications.