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Arch Pathol Lab Med. 2004 Feb;128(2):205-9.

Use of polymerase chain reaction to diagnose tuberculous arthritis from joint tissues and synovial fluid.

Abstract

CONTEXT:

Tuberculosis of the joints and bones is a significant worldwide problem, often leading to joint and bone destruction. The diagnosis of this disease manifestation is difficult.

OBJECTIVE:

To assess the role of conventional diagnostics compared to polymerase chain reaction applied to samples obtained at arthroscopy.

DESIGN:

This was an open observational study that was blinded to the microbiologist, histopathologist, and molecular biologist responsible for assessing the main outcome measures.

PATIENTS:

Seven patients (8 samples) with joint and bone tuberculosis and 14 patients (16 samples) with nontuberculous joint and bone disease.

INTERVENTION:

Arthroscopic examination and tissue sample collection.

MAIN OUTCOME MEASURES:

Mycobacterium tuberculosis staining, culture, and histopathologic assessment of caseating granulomas vs polymerase chain reaction.

RESULTS:

Polymerase chain reaction was positive in all cases of true tuberculosis and falsely identified 2 samples as positive, both however, in patients who had lung tuberculosis in the past.

CONCLUSIONS:

Conventional bacteriological methods for demonstration of M tuberculosis are not very sensitive and can be time-consuming. Polymerase chain reaction of arthroscopically obtained joint tissue biopsies appears promising in the early diagnosis of tuberculous arthritis.

[PubMed - indexed for MEDLINE]
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