| Clinical Review of Bone and Joint Tuberculosis in Korean Children |
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Pyung Kil Kim |
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Department of Pediatrics Yonsei University College of Medicine Seoul, Korea |
| 小兒의 骨 關節結核에 對한 臨床的 考察 |
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金炳吉 |
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延世大學校훌훌科大學 小兒科學敎室 |
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| Abstract |
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Bone and joint tuberculosis, the most common one among the extrapulmonary tuberculosis, has been frequently observed in out-patient dispensaries or in-patient wards in Korea. There are many clinical
reviews about that in Korean literatures. But almost of them are the review of tuberculous spine. Few
of them are the review of bone and joint tuberculosis of the adult None of the review of bone and
joint tuberculosis of children were published in Korea. I have summarized 274 pediatric patients of bone and joint tuberculosis who were observed at Wonju Union Christian Hospital, Wonju, Kang Won Do, a branch hospital of our Severance. The following results were obtained; 1.For 9 years and 3 months from Jan. I960 to March of 1969, 274 patients of bone and joint tuber culosis were observed which was 5. 49% of the total admitted pediatric patients (4. 991) during the above period. 2.The youngest one was a 6 month old male infant of tuberculous spondylitis. One third of patients were between 3 and 6 years of age. Only 1. 7% were under one year of age. 30. 9% were the school age group, from 6 to 12 years of age. Tuberculosis of spine and hip were observed from infancy but that of rib and shoulder were from teen-age group. 3.The ratio of male to female was 1. 74 : 1. 4.The most common site of involvement was the spine which was 52. 9% of the total bone and joint
tuberculosis. The next were hip (28. 9%), knee (9. 8%), ankle (3. 6%), elbow (1. 8%), rib (0. 7%) etc. 5.Their chief complaints on admission were vertebral bending (40. 2%), local pain (36. 3%), local :swelling and tenderness(29. 0%), walking and/or standing disturbance(28. 8%), limitation of motion (19. 2%) etc in that order. 6.Vertebral lesions were found from C 2 to Si but Ll was the most common site of lesion. Major of lesions were located on lower thoracic and lumber vertebrae. Lumbar spondylitis were found in 44. 7 % of all patients of the tuberculous spine. Average involvement was 2. 3 vertebrae per patient. 47. 2% of patients had 2 vertebral lesions. Three was the next (20. 3%). 7.The left side of bone and joint were frequently involved comparing the right side. 8.Pulmonary tuberculosis was the most common complication in bone and joint tuberculosis. All complications were found in 59. 4% of the total patients. 9.Treatment was done by triple therapy with INH, PAS, SM in all recorded cases. Cast was applied frequently than surgical fusion therapy. |
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