Bone and Joint Complications in Hospitalized Brucellosis Patients: A 10-Year Study in Hamadan, Iran

Background and Objective: Brucellosis is a zoonotic disease common in the Middle East, including Iran. Musculoskeletal manifestations, particularly in the spine, are frequent symptoms of brucellosis, often leading to delays in diagnosis due to its varied and non-specific symptoms. The present study aimed to investigate the prevalence, clinical presentation, and diagnostic challenges of musculoskeletal brucellosis, focusing on spinal involvement. Materials and Methods: This retrospective study reviewed the medical records of 782 patients with brucellosis admitted to Sina Hospital in Hamadan, Iran, from 2011 to 2020. Results: The results indicated that a significant portion (87.6%) of the patients had a history of consuming unpasteurized dairy products, and more than half (57.2%) had been exposed to livestock in the past year. The most common clinical symptoms were weakness and fatigue (66.7%), joint pain (62.7%), and fever (73.1%), while back pain (65.7%) and knee pain (48.3%) were the dominant musculoskeletal symptoms. In addition, arthritis (24.4%), spondylitis (15.4%), and sacroiliitis (13.4%) were the primary identified musculoskeletal complications. Conclusion: The clinical manifestations of brucellosis include common symptoms, such as fever, weakness, fatigue, and joint pain, which were more prevalent in male patients. In addition, musculoskeletal complications are prominent features of the disease. According to bone scan and MRI results, approximately 20% of hospitalized brucellosis patients had bone-joint complications, including arthritis, spondylitis, and sacroiliitis.