Elbow Joint Tuberculosis

Elbow TB ranks first among the three major upper limb joints, accounting for 0.92% of systemic osteoarticular TB, most common in young adults; sex and side distribution are roughly equal, with bilateral cases reported. Most patients have TB elsewhere. Though only 5.63% of osteoarticular TB, it is the most common upper limb site.

Common Symptoms

Motor dysfunction; bony destruction; elevated ESR; anorexia; night sweats; low fever; weight loss; abscess

Causes and Pathogenesis

Like systemic TB, the pathogen is Mycobacterium tuberculosis; human and bovine types cause most human disease. It is acid-fast, non-motile, isoniazid-sensitive, and produces nicotinic acid and catalase. Joint TB is secondary, usually to pulmonary or intestinal TB; trauma, malnutrition, or overwork reactivates latent foci that hematogenously seed joints. Pathogenesis: Bacilli cannot directly invade bone/joints, so lesions are almost always secondary; latent bacilli in synovium are walled off by fibrous tissue until fatigue, malnutrition, or declining immunity allows reactivation. Pathology: Giant and epithelioid cell nodules with fibrosis and caseous (non-liquefying) necrosis. Clinical stages: simple osseous TB, simple synovial TB, and total joint TB. At the elbow, total joint TB predominates, followed by simple osseous TB (olecranon most common, lateral humeral condyle next, medial rare). Cancellous osseous TB is usually central (inflammatory infiltration, granulation, caseation, pus, small sequestra that leave cavities); marginal type (vascular, readily absorbed) forms defects and abscesses that easily penetrate into the joint. Synovial TB early shows swelling, congestion, serous effusion; late shows dark red thickened synovium with papillary hyperplasia, tubercles, caseation, and purulent fluid. Untreated lesions drain as sinuses (usually posterior near olecranon) with mixed infection; severe destruction causes pathological dislocation; healing often leaves non-functional fibrous or bony ankylosis.

Treatment

Drug therapy, supportive therapy

Preventive Measures

Since this is secondary, prevention hinges on treating primary pulmonary and intestinal TB. Established lesions require early diagnosis and treatment to shorten the course, reduce disability, and lower recurrence. Besides surgery and anti-TB drugs, ensure rest, immobilization, and nutrition.

Department to Visit

It is recommended to visit the Orthopedic Surgery department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.