The Value of Histology, Culture and Guinea Pig Inoculation Examination in Osteo-Articular Tuberculosis

Tuberculosis is on the decline in affluent countries, but in developing countries it remains one of the major public health problems.Osteoarticular tuberculosis in economically underdeveloped countries of the world remains one of the main conditions to be dealt with in any orthopaedic centre.About 7.5 per cent of the total cases attending the outpatient services of the Orthopaedic Department of the Institute of Medical Sciences, Banaras Hindu University, were those of osteoarticular tuberculosis (Tuli el al. 1967).Availability of effective anti-tubercular drugs has made the treatment of this condition relatively simple and safe provided the diagnosis is accurately made.Clinical and radiological methods which are adopted to diagnose this condition are not always accurate, as many conditions may mimic tuberculosis clinically and radiologically.At the same time osteo-articular tuberculosis does not always present a typical clinical and radiological picture; thus some lesions can be missed.The diagnosis can be accurately established by submitting the material from the suspected lesions for histological examination and/or culture and/or guinea pig inoculation.However, histology alone does not confirm the diagnosis in all cases as the anti-tubercular drugs are now known to change the histological pattern of tuberculous tissue (Wilkinson & Notley 1953).To prove the diagnosis of tuberculosis, ideally speaking, the causative organism must be recovered from the lesion.In the present work an attempt has been made to correlate clinical and radiological observations with those of histological findings and microbiological findings for Mycobacterium tuberculosis.