M. Kowalski et M. Seitz, Tuberculous manifestations in the musculoskeletal system, exemplified by Poncet's disease, SCHW MED WO, 129(47), 1999, pp. 1839-1842
Tuberculosis is a communicable disease that is occasionally complicated by
arthritis, either as part of a disseminated primary infection or through la
te reactivation, often in immunocompromised hosts such as elderly people, H
IV-positive patients or patients under immunosuppressive therapy. Even thou
gh musculoskeletal manifestations occur in only about 2% of tuberculosis ca
ses, they can be very heterogeneous and present as spondylitis, osteomyelit
is or mono-oligo-polyarthritis. Because of the potential for disastrous out
comes in cases where the diagnosis is delayed, it is important to recognise
the multiple rheumatological manifestations of tuberculosis. This case rep
ort on a patient with Poncet's disease discusses a current hypothesis regar
ding pathogenesis of reactive arthritis based on rheumatological manifestat
ions of tuberculosis. The genomic detection of Mycobacterium tuberculosis,
to differentiate between infectious arthritis and reactive arthritis by pol
ymerase chain reaction, is of particular importance.