{"presentation":{"slides":[{"elements":[{"x":4.357298474945534,"y":2.150537634408602,"width":92.5925925925926,"height":68.81720430107526,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

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Can involve head of humerus, glenoid, spine of the scapula, acromio-clavicular joint<\/span><\/strong><\/p>\n\t<\/li>\n\t
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Examination reveals limited external rotation and abduction with muscle wasting (particularly deltoid and supraspinatus)<\/p>\n\t<\/li>\n\t
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In advanced disease, marked destruction of the humeral head and glenoid with muscle atrophy, or deformity (particularly, fibrous ankylosis<\/span> <\/strong>with arm fixed in adduction and internal rotation). <\/p>\n\t<\/li>\n\t
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X-ray: <\/strong><\/span>Osteoporosis, erosion of articular margins, osteolytic lesions, joint space involvement and capsular contracture are seen early in the disease.<\/p>\n\t<\/li>\n\t
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\u201cCaries sicca<\/strong><\/span>\u201d is one of the most common form of shoulder TB \u2013 which is a dry arthropathy (rather than exudative) leading to small pitted erosions on the humeral head. <\/p>\n\t<\/li>\n<\/ul>\n"},"subContentId":"aff2de84-9285-4270-b2f4-53bf62703912","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":"
\u200b\u200b\u200b\u200b\u200b\u200b\u200b<\/p>\n"},{"x":81.69934640522877,"y":90.71274298056156,"width":16.33986928104575,"height":8.639308855291576,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
INDEX-TB guidelines 2016<\/span><\/span><\/span><\/span><\/span><\/p>\n"},"subContentId":"abcf11ea-7e06-4dbf-a84b-5a205376c223","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":81.69934640522877,"y":90.71274298056154,"width":16.33986928104575,"height":8.639308855291576,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
INDEX-TB guidelines 2016<\/span><\/span><\/span><\/span><\/span><\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"713fed08-2236-4f5d-a9cb-acdd3f85ca3a"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":7.298474945533769,"y":28.602150537634408,"width":39.21568627450981,"height":40.86021505376344,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Diagnosis <\/strong><\/span><\/p>\n\n
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Arthroscopic biopsy<\/strong><\/span> for direct visualization of joint, excision of tubercular synovium, granulation tissue, and pannus over cartilage. In advanced disease where arthroscopy is not feasible, an open debridement and biopsy is indicated. <\/p>\n\t<\/li>\n<\/ul>\n\n
<\/p>\n\n
\n<\/ul>\n"},"subContentId":"a27a2269-a760-4dad-8cc5-74fe3550c0d9","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":50.10893246187364,"y":30.10752688172043,"width":47.930283224400874,"height":67.09677419354838,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Management<\/strong><\/span><\/p>\n\n
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12 months of ATT: 2RHZE\/10RHE<\/strong><\/span> with rest in sling or brace and gentle mobilization<\/p>\n\t<\/li>\n\t
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Prolonged immobilization with spica is no longer widely advocated. <\/p>\n\t<\/li>\n\t
\n\t
Surgery is rarely needed, but may be indicated for drainage of large abscess, joint debridement to remove loose bodies and pannus, arthrodesis<\/span> <\/strong>to relieve a painful fibrous ankylosis, or joint replacement<\/strong><\/span> in healed disease with severe joint destruction. <\/p>\n\t<\/li>\n<\/ul>\n"},"subContentId":"18cd0374-e0cd-4671-be2e-d0770a5eee48","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":21.78649237472767,"y":6.451612903225806,"width":10.893246187363834,"height":21.29032258064516,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-6651e779738d1.png","mime":"image\/png","copyright":{"license":"U"},"width":147,"height":146}},"subContentId":"d6d5e8d3-cac7-4e3f-bf44-4c664cd3dd51","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":68.62745098039215,"y":6.451612903225806,"width":10.778272961395817,"height":21.29032258064516,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-6651e7cb5f6db.png","mime":"image\/png","copyright":{"license":"U"},"width":128,"height":128}},"metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"f877a70e-2174-4b0c-be59-2e7e8ed9b0f8"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":47.930283224400874,"y":32.21763440860215,"width":0.32679738562091504,"height":62.36559139784946,"action":{"library":"H5P.Shape 1.0","params":{"line":{"borderWidth":"2","borderStyle":"dotted","borderColor":"rgb(201, 201, 201)"},"type":"vertical-line","shape":{"fillColor":"#ffffff","borderColor":"#000000","borderWidth":"0","borderStyle":"solid","borderRadius":"0"}},"subContentId":"14576469-5fbf-483c-b2e7-5a3729dbcc54","metadata":{"contentType":"Shapes","license":"U"}},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false}],"slideBackgroundSelector":{}}],"keywordListEnabled":true,"globalBackgroundSelector":{},"keywordListAlwaysShow":false,"keywordListAutoHide":false,"keywordListOpacity":90},"override":{"activeSurface":false,"hideSummarySlide":false,"summarySlideSolutionButton":true,"summarySlideRetryButton":true,"enablePrintButton":false,"social":{"showFacebookShare":false,"facebookShare":{"url":"@currentpageurl","quote":"I scored @score out of @maxScore on a task at @currentpageurl."},"showTwitterShare":false,"twitterShare":{"statement":"I scored @score out of @maxScore on a task at @currentpageurl.","url":"@currentpageurl","hashtags":"h5p, course"},"showGoogleShare":false,"googleShareUrl":"@currentpageurl"}},"l10n":{"slide":"Slide","score":"Score","yourScore":"Your Score","maxScore":"Max Score","total":"Total","totalScore":"Total Score","showSolutions":"Show solutions","retry":"Retry","exportAnswers":"Export text","hideKeywords":"Hide sidebar navigation menu","showKeywords":"Show sidebar navigation menu","fullscreen":"Fullscreen","exitFullscreen":"Exit fullscreen","prevSlide":"Previous slide","nextSlide":"Next slide","currentSlide":"Current slide","lastSlide":"Last slide","solutionModeTitle":"Exit solution mode","solutionModeText":"Solution Mode","summaryMultipleTaskText":"Multiple tasks","scoreMessage":"You achieved:","shareFacebook":"Share on Facebook","shareTwitter":"Share on Twitter","shareGoogle":"Share on Google+","summary":"Summary","solutionsButtonTitle":"Show comments","printTitle":"Print","printIngress":"How would you like to print this presentation?","printAllSlides":"Print all slides","printCurrentSlide":"Print current slide","noTitle":"No title","accessibilitySlideNavigationExplanation":"Use left and right arrow to change slide in that direction whenever canvas is selected.","accessibilityCanvasLabel":"Presentation canvas. 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TB of Shoulder

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TB of Shoulder

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