SA Orthopaedic Journal
On-line version ISSN 2309-8309
Print version ISSN 1681-150X
AIM: To describe the clinical and radiological manifestations of tuberculosis of the hip joint and the resemblance to common osteoarticular lesions in children. METHODS: Thirty-six children (1 to 12 years) were reviewed retrospectively between 1990 and 2011. Clinical, laboratory and radiological features were assessed. The hips were classified and the outcome was graded as described by Shanmugasundaram. RESULTS: Common clinical features were a limp, flexion, adduction and internal rotation contractures. Common radiological features were osteopaenia and cystic lesions in the neck and acetabulum. Permeative lesions, focal erosions, pathological fractures and sequestra were less common. Seven children had extra-articular lesions. Of the 29 with osteoarticular involvement, six had purely synovial involvement. Osteoarticular lesions mimicked benign bone and joint conditions. Follow-up was 1 to 6 years, 36% were graded as good, 36% fair and 28% had poor outcome with ankylosis. Other complications included avascular necrosis, coxa vara, coxa magna, growth arrest and flexion-adduction contractures. CONCLUSION: Tuberculosis of the hip can mimic various benign conditions. Biopsy from a bony lesion is important. The initial radiological appearance predicts the outcome, especially in the 'normal' type of hip.
Keywords : tuberculosis; hip joint; children.