Background Osteoarticular tuberculosis (OAT) is still common in Mediterranean countries such as Tunisia.The incidence of OAT is increasing, mainly related to expanding immunosuppressive factors and comorbidities.
Objectives This study aimed to analyze the prognostic factors and therapeutic outcomes of OAT.
Methods Over a period of 20 years [1996- 2016], patients with the diagnosis of OAT were retrospectively identified. Clinical, laboratory and radiology features in these patients were analyzed to identify the prognostic factors.
Results Sixty patients (29 men) fulfilled the diagnostic criteria, admitted to the Rheumatology Service with an average of 54 years (range: 16 to 86).We did not find any significant association between prognosis and an advanced age (>60years) at the time of diagnosis, a long diagnostic delay or initial neurologic involvement.However, we found that cervical localization in tuberculous spondylodiscitis, classified as an only infection site or in multi-level vertebral damage, was significantly associated to a poor prognosis.Our study revealed that hyperleucocytosis higher than 11500 elements/mm3 at the initial blood count constituted the only biological bad prognostic factor during OAT. Based on radiological findings, the presence of abscess or vertebral compression fractures on bone imaging (MRI)and the presence of vertebral deformity (kyphosis or kyphoscoliosis) were strongly linked to a bad outcome.The following table (Table1) summarizes the poor prognostic factors during OAT.
Conclusions This study revealed that cervical localization in tuberculous spondylodiscitis, initial hyperleucocytosis, and the presence of abscess on MRI as well as vertebral compression fractures and vertebral deformity are associated with a bad outcome in OAT.
Disclosure of Interest None declared