This study discusses the difficulties in making the diagnosis of bone and joint tuberculosis and underlines the diagnostic value of tissue biopsy from the site of the suspected tuberculosis lesion. Fifty-two patients, suffering from this disease, underwent treatment at our hospital between 1980-1986. In 27 cases (51%) the diagnosis was made on the basis of the clinical picture and various tests not including biopsy. The other 25 cases (48%) required a biopsy, and tissue specimens were sent for histological examination and culture with the Löwenstein-Jensen medium. In 9 (17.3%) patients the biopsy was performed early, while in another 16 (30.8%) patients there was a delay (23 months on average). From the total of 25 biopsies the histological examination showed findings compatible to tuberculosis in 23 (92%), while the culture of the same material was positive only in 10 (40%). The high rate of diagnostic accuracy with the biopsy, proves that this method is probably the most useful one for the diagnosis of bone and joint tuberculosis and emphasizes the need to use this method more often.
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