Knee Tuberculosis

The knee is the third most common site for skeletal tuberculosis after the spine and hip. When tuberculosis from the lungs is transferred to the knee through blood vessels, it is known as best knee tuberculosis. Commonly affected patients are relatively older children and young adults.


The origin of TB in the knee can be:

  • Synovial
  • On the bone articular surface of the patella, femur, and tibia.
  • On the bone non-articular parts of the tibia and femur

Most cases of TB knee start in synovial and tend to remain purely so for a long time. The infection then spread to the cartilage, reducing the joint space.

Everything to know about knee Tuberculosis

Causes of Knee Tuberculosis

Knee tuberculosis is caused when the infection spread to the knee region from the lungs. The lungs are the first region to be affected by tuberculosis which further gets transferred to other organs through blood vessels. Knee Tuberculosis cannot be spread from person to person but lung tuberculosis can be spread by the exchange of blood and body fluids of the infected person which infects the other organs.


Malnutrition, environmental conditions, and living standards such as poor sanitation, overcrowded housing, and slum dwellings are some factors that lead to Tuberculosis.

Symptoms of Knee Tuberculosis

  • Most of the patients tend to present with pain, stiffness, and swelling in the knee that is of long duration.

  • Sinuses may appear either discharging or healed with small folds of skin.

  • Patients might experience pain in flexion and extension.

  • On examination, doughy thickening may be observed in the patellar region.

  • After 3 to 4 weeks of infection, MRI can show soft tissue swelling in the knee region.

Diagnosis of Knee Tuberculosis

  • X-Ray: In the initial stages X-ray shows the reduction in joint space and articular erosions. Late cases show total deformity of the knee.

  • MRI: It is needed in cases where the X-ray findings are uncertain. MRI can demonstrate pus collection, synovial thickening as well as bone deformity.

  • Biopsy: Arthroscopic biopsy is generally preferred. With the help of arthroscopic biopsy, the rice bodies are easily visible inside the joints.

Treatment of Knee Tuberculosis

The treatment of knee tuberculosis is same as the hip tuberculosis. Tuberculosis of the knee is said to be active when the hip is extremely painful with the presence of fever, weight loss, and low appetite. On examination, there is a rise in local temperature, the knee is tender, and the range of motion is painful. The process involved in knee treatment is:

  • ATT (Anti-tubercular therapy) is started in all patients. The knee deformity can be reduced with the help of “double traction”.

  • As the deformity reduces and the injury enters the healing phase, traction is removed and a plaster cast is given once the injury starts to heal, range of motion starts to recover.

  • The patients can walk using walkers or crutches for 18-24 months, and later patients can start walking without support too.

FAQs

If you come in contact with a patient having TB of the lungs, it can be spread to your body too. TB can be spread to other organs through blood vessels. When the infection from the bacteria spreads to the knee, the patient can get TB in the knees.

TB is not contagious if detected and treated with proper medications. But it can harm the human body over time. It weakens the immune system which makes you sick.

If the infection is not treated properly at the right time with the help of ATT, surgery can be recommended by the doctors depending on the severity of your health and your knee condition.