Radiologic review of knee joint tuberculosis: relationship with intraarticular steroid injection

We reviewed radiologic and clinical findings in 44 patients with tuberculous arthritis of the knee, especiallyin regard to the history of intraarticular steroid injection, from Jan. 1988 to Dec. 1989. The results were asfollows: 1. Age distribution was widely varied from 10 to 74 years(mena:52 years) and women were 3 times morecommonly affected than men. 2. About 20% of the patients were associated with pulmonary tuberculosis and two ofthem were active. 3. The positive rate of AFB stain and culture of the aspirated joint fluid was 43% and 56%respectively and that of biopsy was 98%. 4. Radiologic findings were soft tissue swelling and joint effusion(84%), cortical bone destruction (50%), joint space narrowing(48%), periarticular osteoporosis(30%), subchondralcyst(27%) and other associated findings such as spurs, loose body, synovial calcification, periosteal reaction andbony ankylosis. 5. About 82% of the patients had a history of previous intraaticular steroid injection. Knee jointtuberculosis seems to be related with intraarticular steroid injection, although it's epidemiologic study shouldbe done. Tuberculous arthritis is suggested when the radiologic findings mentioned above are seen in unilateralknee, especially in patients with a history of intraarticular steroid injection, and in these case we should keepin mind to perform joint fluid analysis or synovial biopsy for confirmation.