Characteristics and Clinical Outcome of Bone and Joint Tuberculosis From 1994 to 2011: A Retrospective Register-based Study in Denmark

Background. Most information on bone-joint (BJ)-tuberculosis is based on data from high-incidence areas. We conducted a nationwide register-based analysis of BJ-tuberculosis in Denmark from 1994 to 2011. Methods. We linked data from the national tuberculosis surveillance system on BJ-tuberculosis, hospital records, the Danish Hospital and Civil Registration System. Results. We identified 282 patients with BJ-tuberculosis, 3.6 % of all tuberculosis cases (n = 7936). Spinal tuber-culosis was found in 153 of 282 patients (54.3%); 83.3 % of all cases were immigrants. Danes were older and had higher Charlson comorbidity index scores than immigrants (P <.01). C-reactive protein and erythrocyte sedimen-tation rates were elevated in most cases. Median time to diagnosis after first hospital contact was 19.5 days for spinal tuberculosis and 28 days for other forms of BJ-tuberculosis (P =.01). Of patients with spinal tuberculosis, 54/133 (40.6%) had neurologic deficits at admission and 17.3 % presented with cauda equina. Diagnosis was culture verified in 87%. (Resistance to any drug was found in 10.2%). Median time on antituberculous treatment for patients with spinal and other forms of BJ-tuberculosis was 9 months and 7 months, respectively (P <.01). Surgery was required in 44.4 % patients with spinal tuberculosis and in 32.6 % patients with other forms of BJ-tuberculosis (P =.04). Sequelae were reported in 57.5 % of patients with spinal tuberculosis and 29.1 % of patient with other forms of BJ-tuberculosi