An Analysis of Adult Skeletal Tuberculosis

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Abstract
Data were presented from a series of 230 consecutive adult patients with well proved, active, skeletal tuberculosis. It was found that a majority of the patients were young men and that the disease was located in weight-bearing joints, especially in the axial skeleton. The lesions were usually of advanced extent and were often associated with other tuberculous conditions, especially pulmonary tuberculosis, other skeletal tuberculosis foci, genito-urinary tuberculosis, previous pleural effusion, abscesses and drainage. During the six to twenty-five-year follow-up period there was a mortality rate due to tuberculosis of 57 per cent for all patients and a relapse rate of 39 per cent for all patients discharged. It was shown that factors which had proved to be statistically significant in relation to an increased mortality rate were the location of the lesion, the extent of the lesion, the presence of multiple skeletal foci, and the presence of pulmonary tuberculosis. With the material on the 230 patients used as a comparative group depicting the disease prior to the use of streptomycin, comparisons were made with two other groups of patients who received streptomycin. It is inferred that the effect of streptomycin on the osseous component of tuberculosis is slight but definite.

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