Tuberculous Lesion after Local Steroid Injections - Shoulder and Posterior Compartment of the Lumbar Spine -

Suk, Se Il; Shin, Byung Joon; Cha, Seung Ik; Lyu, Suk Joo

Abstract

Local steroid injection is applied for the various problems in orthopaedic fields. Its not well known whether local steroid injection can induce or aggrevate the tuberculous lesion of the injection site. Tuberculous lesion of the shoulder and posterior compartment of the lumbar spine is rare, but rather commonly noted in the steroid injection group. Fifteen patients of tuberculous lesion(8 in shoulder and 7 in posterior compartment of the lumbar spine) after local steroid injection were treated surgically at the Department of the Orthopaedic Surgery, College of Medicine, Seoul National University, from Jan. 1980 to Agu. 1986, and following results were obtained; 1. The highest incidence was in the 6th decade and male to female ratio was 2: 13. 2. The average number of the injection was 16 times and the average duration was 6 months. 3. The duration from the last steroid injection to the first sign of the tuberculous lesion was from 2 weeks to 3 months and average 2.4 months. 4. Of the 15 cases, active tuberculous lesion at other sites were associated in 6 patients. 5. All cases were treated by complete curettage. It took 5.2 months for the primary wound healing. 6. Local steroid injection could induce or aggrevate the local tuberculous lesion. Radical extirpation of the lesion is the treatment of choice, but with high recurrence rate.