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Table 3: the parallels between TB and the sero-negative arthritides

 

TUBERCULOSIS

SERO-NEGATIVE ARTHRITIDES

ORAL ULCERS (up to 20% affected at autopsy)
 

RAU

EPIDIDYMO-ORCHITIS
 

BS Sa

ERYTHEMA-NODOSUM
 

BS RS UC CD Sa

INTESTINAL DISEASE
with fistulation, resembling CD
 

BS Crohn's disease [78]

ARTHROPATHY

a) mild non-bacterial

b) bacterial involving SI joints, hips, knees, shoulders in descending order of prevalence

c) Pott's disease of the spine

d) TB tenosynovitis
 

 

All

All have the same predilection for joints but no bacterial infection
 

AS may masquerade as Pott's disease [79]

RS BS

PLEURO-PERICARDO-PERITONITIS
 

SLE (all) & heart only in BS UC and Sa

ENCEPHALO-MYELITIS[80]
 

RS BS Sa SLE MS UC

APICAL PULMONARY CAVITATION

AS produces a clinically identical picture without TB bacillus infection [81]
 

LUPUS VULGARIS
 

Sa Discoid Lupus

OPHTHALMITIS

a) phlyctenular conjunctivitis

b) periphlebitis retinae
 

 

All associated with conjunctivitis

BS Sa

ADDISON'S DISEASE
 

Idiopathic (auto-rejective) Addison's

FAMILIAL AGGREGATION
of cases and genetic
 

All predisposed

STRESS PRECIPITATION
and emotional factors [82]
 

Most

STEROID REPONSE
Paradoxical initial improvement. Steroids and immunosuppressives lead to improvement of X-rays and amelioration of the acute features

 

All respond