Focal Tuberculin Reaction (FTR) in Bone and Joint Tuberculosis

Abstract

1. The author has ascertained that the tissues, especially the skin, in the neighborhood of the foci in osteoarthritic tuberculosis cases are in a state of localized tuberculous allergy specifically different from that in tissues distant from the foci, and the significance of the Focal Tuberculin Reaction (FTR) was discussed.
2. The intracutaneous tuberculin reaction test applied in the skin over a focus of osteoarthritic tuberculosis resulted in a reaction much different in degree from that on the healthy area, and this difference was found to change parallelly with the progress or the stages of the disease. Thus, a test for this difference of FTR is deemed clinically serviceable in differential and prognostic diagnosis. In non-tuberculous orthopedic diseases such a difference of FTR was scarcely observable, except in rheumatic cases.
3. As to the nature of such a difference in FTR, the author's opinion is that it represents a difference in the strength of the reaction owing to a difference in ratio of the antigen to the antibodies in and around the focus. Another factor, a difference in susceptibility of the tissues to the reaction was also considered, but this was found insignificant, both clinically and experimentally.
4. From the above results, we are justified in concluding that FTR is a specific manifestation of the antigen-antibody reaction in the focus of osteo-arthritic tuberculosis.