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Introduction Osteoarticular TB constitutes 1-3 % of cases of which about 10% affects the foot and ankle. In foot TB, calcaneus is the most commonly affected bone. Presentation of case Here we report a 21 year old male presented with pain, swelling in right heel since 5 months and difficulty in walking since 2 months. Plain x-ray (axial) view of calcaneus shows a lytic lesion in calcaneus. Biopsy was done under local anaesthesia and histologic examination reveals a characteristic granuloma, caseous necrosis, and Langhan’s giant cells which confirm our diagnosis of TB. Patient was treated with Anti–TB chemotherapy for 12 months. Radiographs done at 18 months of follow-up showed a healed lesion. Discussion TB calcaneus is rare entity, so a high index of clinical suspicion with positive imaging finding, characteristic histopathological features and staining for acid –fast bacilli could help us in diagnosis. Conclusion Conservative management with adequate anti-TB chemotherapy along with immobilization can result in complete resolution of the infection with good functional results. Surgery is indicated for cases resistant to chemotherapy, deformity correction and joint reconstruction. |
