Senile Tuberculous Arthritis
In 1879 Sir James Paget1 said, “It is, I think, too often taken for granted that scrofula is almost exclusively a disease of the earlier part of life. Doubtless, young persons are much more often subjects of scrofula than are those of later years; but the old, i.e., people over 60, are, I believe, more often scrofulous than those between 30 and 50, and certainly are more often so than they are generally supposed to be.” Although Sir James Paget was speaking in general of all extrapulmonary tuberculous disease, the statement is none the less applicable to tuberculous disease of the joints.
It is a fact that tuberculosis of the joints is found almost entirely in young people and a review of the literature on the subject leads one to believe that its occurrence in old people is indeed rare.
Whitman2 reports 5,461 cases of tuberculosis of joints with only 17.5 per cent of the cases occurring in patients who were more than twenty-one years of age and in only one patient who was more than fifty years of age. In a review of 1000 cases of tuberculosis of the knee joint, he found no patients more than fifty years of age. However, in Alfer's3 table of statistics compiled from records in Trendelenburg's clinic at Bonn, 966 cases of tuberculosis of the joints were reported among which there were fifty cases (5.1 per cent) in patients who were more than fifty years of age and sixteen in patients more than. . .