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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Vielgut, I; Putzl, L; Thomüller, I; Igrec, J; Brcic, I; Valentin, T; Wittig, U; Zettl, R; Sadoghi, P; Leithner, A; Fischerauer, S; Scheipl, S.
Musculoskeletal tuberculosis revisited: bone and joint tuberculosis in Austria.
Arch Orthop Trauma Surg. 2022; 1-11 Doi: 10.1007/s00402-022-04615-x [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Scheipl Susanne
Vielgut Ines
Co-Autor*innen der Med Uni Graz
Brcic Iva
Fischerauer Stefan Franz
Igrec Jasminka
Leithner Andreas
Sadoghi Patrick
Valentin Thomas
Wittig Ulrike

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BACKGROUND: To prevent further spread of the disease and secondary deformity, musculoskeletal tuberculosis (TB) remains a challenge in terms of early diagnosis and treatment. This study gives an overview on TB trends in Austria (pulmonary and extrapulmonary TB) (A) and analyses a retrospective series of musculoskeletal TB cases diagnosed and treated at an Austrian tertiary centre (B). METHODS: (A) We analysed data obtained from the Austrian national TB registry to provide information on TB patients´ demographics and manifestation sites between 1995 and 2019. (B) Furthermore, we performed an observational study of all patients with a confirmed diagnosis of musculoskeletal TB who were admitted to the Department of Orthopaedics and Trauma, Medical University of Graz (2005-2019). Demographic, diagnostic, clinical and follow-up data were retrieved from the medical records. RESULTS: (A) From 1995 to 2019, a significant linear reduction in overall Austrian tuberculosis incidence rates occurred (p < 0.001). In the period investigated, Austria recorded a total of 307 patients with musculoskeletal TB. (B) Our retrospective case-series included 17 individuals (9 males, 8 females; average follow-up 48.4 months; range 0-116). There was a biphasic age distribution with a peak in elderly native Austrians (median 69, range 63-92), and a second peak in younger patients with a migration background (median 29, range 18-39). Sites of manifestation were the spine (n = 10), peripheral joints (n = 5), and the soft tissues (n = 2). Diagnosis was based on histology (n = 13), PCR (n = 14), and culture (n = 12). Eleven patients underwent surgery (64.7%). Secondary deformities were frequent (n = 9), and more often observed in patients with spinal TB (n = 6). CONCLUSION: Musculoskeletal TB should be considered if untypical joint infections or nonspecific bone lesions occur in younger patients with a migration background or in patients with specific risk factors.

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