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Skeletal Tuberculosis (Part-2) Dr. Sunil Arora Junior Resident Deptt. of Chest TB Govt. Medical College, Patiala. ;Introduction;Classification ;Pathogenesis;Metaphyseal infection reaches the joint through subperiosteal space by penetrating the capsular attachment.In adults,the inflammation can spread up to the subchondral area and enter the joint at the periphery where synovium joins the cartilage which leads to the loosening the attachment of articular cartilage and joint displacement. ;Sometimes the synovium is infected first and the bone is infected secondarily.It is usually in the form of low-grade synovitis with thickening of the synovial membrane and leading to the formation of pannus.Eventually,the articular cartilage is destroyed,joint gets distended with pus,which may burst out to form a cold abscess or discharging sinus.The joint may also get subluxated due to the laxity of the joint capsule and ligaments. Fibrous ankylosis is a common outcome of healed tuberculosis of the joints except in spine where bony ankylosis follows more often.;Types;Clinical Features;;Investigation;Other investigations;Treatment;;Rest and brace Affected part should be rested during active stage of the disease.In upper limbs this can be done with the help of plaster slab and in lower limbs traction can be applied. As the disease comes under control and the pain reduces,joint mobilization is begun.Gradual mobilization should be encouraged with the help of suitable braces/appliances after 3-6 months of start of treatment when the healing is progressing, which are gradually discarded after about 2 years. Exercise is started as the joint regains movement and weight bearing started gradually as osteoporosis secondary to disease is reversed In presence of gross destruction especially in weight bearing joints, immobilization may be continued to obtain sound a