Left Middle Phalanx Tuberculous Dactylitis Masquerading as a Tumor: First Case Report in Saudi Arabia.

Autor:	Nukaly HY; From the College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi Arabia.; Department of Orthopedic Surgery, Saudi German Hospital, Jeddah, Saudi Arabia., Ahmed RA; From the College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi Arabia.; Department of Orthopedic Surgery, Saudi German Hospital, Jeddah, Saudi Arabia., Mousa AH; From the College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi Arabia.; Department of Orthopedic Surgery, Saudi German Hospital, Jeddah, Saudi Arabia., Moallem AA; From the College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi Arabia.; Department of Orthopedic Surgery, Saudi German Hospital, Jeddah, Saudi Arabia., Zubair MTM; From the College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi Arabia.; Department of Orthopedic Surgery, Saudi German Hospital, Jeddah, Saudi Arabia., AlAidarous HAA; Department of Orthopedic Surgery, Saudi German Hospital, Jeddah, Saudi Arabia.; Faculty of Medicine, Surgery Department, Albaha University, Dubai Health, Dubai, United Arab Emirates., Alshanberi AM; From the College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi Arabia.; Department of Community Medicine and Pilgrims Health Care, Umm Alqura University, Makkah, Jeddah, Saudi Arabia., Albalawi IAS; Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia., Abbas F; Consultant Orthopaedic and Trauma Surgery, Saudi German Hospital, Jeddah, Saudi Arabia.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2024 Sep 16; Vol. 12 (9), pp. e6142. Date of Electronic Publication: 2024 Sep 16 (Print Publication: 2024).
DOI:	10.1097/GOX.0000000000006142
Abstrakt:	Tuberculous dactylitis can cause osteomyelitis, which is a rare extrapulmonary manifestation of tuberculosis, often misdiagnosed due to its nonspecific presentation and resemblance to other conditions like neoplasms. A 15-year-old male patient reported to our clinic with a 1-year history of left index finger pain and swelling following a football-related injury. Despite conservative management, the symptoms had progressively worsened over the past few months. Clinical examination revealed deformity and swelling of the middle phalanx, along with induced pain on range of motion. Bacteriological analysis indicated polymorphic nuclear cells and the presence of coagulase-negative Staphylococcus ( Staphylococcus hominis ). Radiographic evaluation, including x-ray and magnetic resonance imaging, revealed medullary expansion, trabecular thinning, and focal soft tissue swelling. Magnetic resonance imaging displayed extensive soft tissue and bone marrow involvement, raising concerns of a tumor. An open biopsy was performed, yielding unexpected findings of necrotizing and suppurative granulomatous inflammation, strongly suggesting an ongoing infectious process. The subsequent Quantiferon TB Gold Test confirmed tuberculosis infection. Treatment encompassed debridement, synovectomy, and initiation of an antituberculosis regimen. The patient showed significant improvement after treatment. Timely diagnosis and treatment of tuberculous dactylitis are crucial, as highlighted by the patient's positive response to combined surgical and pharmacological intervention, despite initial diagnostic challenges. Competing Interests: The authors declare no financial interests or commercial associations that could pose or create a real or perceived bias in relation to the content of this article. Specifically, the authors have no employment, stock ownership, consultancy roles, honoraria, patents, or funding related to the subject of this article. All potential conflicts of interest for the author group have been disclosed and no new conflicts have arisen since submission. (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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