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Tuberculosis- hip joint

Dr Shital Parikh
Assistant Professor, Division of Orthopaedic Surgery,
Cincinnati Childrens Hospital Medical Center,
Ohio

Q: I had developed unusual pain in the hip joint which was diagnosised as Tuberculosis.I started taking the TB treatment in month of February 2001.In may2001 I had to be operated because there was a cold abscess in the groin area which was drained. I had done an MRI in february & it had not revealed any problem.I did another MRI start of may & it showed this abcess in the groin area however the hip joint & the spinal cord came out clean.Till feb to May there was no increase in weight & no positive symtom after starting anti TB treatment.Some time around june 2001 to July 2001 my weight increased by around 1.5 kgsThe pain I had in the hip location almost disappered in June 2001.Around september 2001 however the groin area where I was operated developed some swelling once again.There is no pain like I had before.Till date I am continuing with the antiTB treatment (since february2001).My weight has increased by 8 kGS since operated.Why has the swelling come at the same location& how it will recede.Sometime I feel the slight stress or pain at the joint othrewiuse there is no problem . I can play tenis now. Though I do avoid doing very strainious things to stress my hip joint.Earlier I was limping when I used to walk.when can I say I am completely cured of this or is it some other kind of TBAlso my blood & the cold abcess was send for culture & both of them did not come out positiv after 6 weeks of culture.The TB in my body was proved because in the chest they found one small spot which was suggestive of this.

A:Weight gain is a good sign of recovery. Relapse inspite of anti-tb drugs may occur,if the mycobacteria acquire resistance. If you have a doubt, that there is recurrence of the swelling, i think you should see an ortho surgeon. you might need an ultrasound to see if there is any abscess. The initial abscess, if it involved the bone, then you have to continue anti-tb drugs atleast 9 months. Activity, anti-tb drugs, cessation of smoking if you smoke, better health status, should benefit.