Tuberculosis of bones and joints, multiple sites
Chapter 1:Certain infectious and parasitic diseases
ICD-10 A30.5 is a billable code used to indicate a diagnosis of tuberculosis of bones and joints, multiple sites.
Tuberculosis of bones and joints, particularly affecting multiple sites, is a serious manifestation of extrapulmonary tuberculosis caused by Mycobacterium tuberculosis. This condition typically arises from hematogenous spread of the bacteria from a primary pulmonary infection or from direct extension from adjacent infected tissues. The most commonly affected sites include the spine (Pott's disease), hips, knees, and other joints. Patients may present with localized pain, swelling, and reduced mobility in the affected areas. Diagnosis is confirmed through imaging studies such as X-rays or MRI, and microbiological tests including culture or PCR of synovial fluid or bone biopsy. Treatment involves a prolonged course of antitubercular therapy, typically including isoniazid, rifampicin, pyrazinamide, and ethambutol, administered for at least 6-12 months. Resistance patterns, particularly multidrug-resistant tuberculosis (MDR-TB), complicate treatment and require careful monitoring and potential use of second-line agents. Early diagnosis and appropriate treatment are crucial to prevent long-term complications such as joint deformities and chronic pain.
Detailed history of exposure, symptoms, and treatment response.
Patients presenting with joint pain and a history of tuberculosis.
Need for thorough documentation of treatment adherence and resistance testing.
Imaging results, surgical notes if applicable, and follow-up care.
Surgical intervention for abscess drainage or joint stabilization.
Documentation of the surgical procedure and its relation to tuberculosis.
Used for joint aspiration in suspected cases of tuberculosis.
Document indication for aspiration and results.
Orthopedic or Infectious Disease specialists may perform this procedure.
Common symptoms include localized pain, swelling, fever, and reduced mobility in the affected joints or bones.
Diagnosis typically involves imaging studies such as X-rays or MRI, along with microbiological tests like culture or PCR from affected tissues.
Treatment usually involves a combination of antitubercular medications for at least 6-12 months, depending on the severity and presence of drug resistance.
Complications can include chronic pain, joint deformities, and systemic spread of the infection.
