212 THE JOURNAL OF BONE AND JOINT SURGERY BCG OSTEOMYELITIS EXPERIENCE IN THE STOCKHOLM REGION OVER THE YEARS 1961-1974

Eighteen cases of bone and joint tuberculosis in children were diagnosed in the Stockholm region (about 1,500,000 population) over the period 1961-1974. BCG infection was verified by culture and identification of bacterial type in seven, all after 1968. The same origin can be presumed in most of the remaining eleven cases, in spite of the absence of bacterial verification. The increased frequency of complications after BCG vaccination may necessitate a revision of the vaccination programme. We recommend operative freatment, which has not led to any growth disturbance or impairment of joint function, although the lesions were invariably localised close to growth zones and joints. Complications from BCG vaccination are un-common. The most serious is generalised BCG infection (Thrap-Meyer 1954; Waaler and Oeding 1954; Ustvedt 1956; Horwitz and Meyer 1957); thirteen deaths from this cause were reported by Mande (1968) from the world literature. Bone and joint tuberculosis after BCG vaccination has been described mostly by Scandinavia