骨结核英文淡七年制.pptVIP

TUBERCULOSIS of BONES JOINTS  Li Qiang  Introduction Tuberculosis of bones and joints Generally to be a chronic inflammatory and infectious disease caused by Myobacterium tuberculosis . Extrapulmonary secondary diseases Approximately 95% cases of tuberculosis of bones and joints are due to pulmonary tuberculosis, but pulmonary tuberculosis is evident in only half the patients with skeletal involvement. Epidemiology In general, most patients with this disease are in the age of 30 or below at diagnosis in developing countries The susceptible population with this disease is in the elderly in developed countries. Both sexes are equally affected. Epidemiology Tuberculosis of spine is the most common site, the next in order of frequency being the knee, hip, ankle, sacroiliac, shoulder, and wrist joints. In Summary Tuberculosis of bones and joints is a granulomatous inflammation caused by Myobacterium tuberculosis. About 5% of tuberculosis is musculoskeletal. 最常见的肺外继发性结核 Tuberculosis of spine is the most common site, the next in order of frequency being the knee, hip, ankle, sacroiliac, shoulder, and wrist joints. 脊柱结核最常见 Etiology Pathogen (致病菌) Acid-fast bacilli Mycobacterium tuberculosis Human tubercle bacilli （人型结核杆菌）common Bovine tubercle bacilli (牛型结核杆菌) rare Etiology On March 24, 1882, Robert Koch announced his discovery of the tubercle bacillus. He discovered a staining technique that enabled him to see Mycobacterium tuberculosis. （结核杆菌） Etiology Transmission Routes Hematogenous dissemination （血液传播）to long bones and vertebrae Direct spread to bone from adjacent tuberculous lymphadenitis （结核性淋巴腺炎） Single or multi centric（单发或多中心）， particularly in AIDS Predilection for synovium （偏好滑膜）- higher oxygen pressure Pathology (病理) Initial pathological changes are tuberculous osteomyelitis (结核性骨髓炎,单纯骨结核) and synovial tuberculosis(滑膜结核)。 The articular cartilages remain intact at this stage. The lesion will be healed through proper treatmen