Q: I sustained a light knee injury 12 years ago. I ignored it and gradually a small lump like formation appeared at the site of the injury. After 5 years, it converted into morning stiffness and occasionally light pain . After 10 years, an arthoscopic surgery was carried out and it was discovered as a case of joint tuberculosis. Its been 4 years since I have been taking anti TB medicines. But the stiffness and pain in joint still persists. In the mean time a femur bone fracture occurred in the left leg, which already had stiffness. Surgery was done and a metallic strip was inserted in it. Now the fracture is healing very satisfactorily as suggested by the x-ray but the knee joint stiffness has started again. Should I continue TB medicines after 4 year of taking it? Please advise about the joint cartilage? The gap between the bone joints has reduced a lot. Is there a test that can detect whether I am 100% cured from joint tuberculosis?

A:There is no need for you to continue anti-tuberculosis medicine unless there is a clear evidence of tuberculous infection some where. If you had anti-tuberculosis treatment earlier all the more reason you should not do it. The presence of infection is suggested by indirect evidences like; pain, fever, weight loss or such similar constitutional symptoms. These could be helped by evidence of destruction of bone/erosion of bone or joint with loss of bone density with or without presence of pus in the region. It could also be suggested by laboratory evidence of a raised ESR and demonstration of tubercle bacteria in the pus or tissue taken for biopsy. Mere presence of pain in the joint and stiffness is not an indication of activity of disease as these indicate that the joint cartilage is damaged. There are no specific medicines to improve your cartilage line. There are a number of drugs available in the market, however they are all empirical. Some stiffness is likely to persist even after complete healing of the disease. There are no fool proof methods to diagnose tuberculosis and no method to say you are 100% cured.