A rare presentation of isolated carpal bone tuberculous osteomyelitis mimicking gouty arthritis

Autor: Mohamed Faisal Abdul Hamid, Suvindran Raj Rajandiran, Andrea Ban Yu-Lin, Jamari Sapuan
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: International Journal of Mycobacteriology, Vol 9, Iss 3, Pp 325-328 (2020)
Druh dokumentu: article
ISSN: 2212-5531
2212-554X
DOI: 10.4103/ijmy.ijmy_97_20
Popis: Tuberculosis (TB) is the most prevalent infectious disease in Southeast Asia. It causes both pulmonary and extrapulmonary diseases. TB of the wrist is rare and presents as osteomyelitis or tenosynovitis. We report a middle-aged male with carpal bone tuberculous osteomyelitis. He presented with left wrist pain initially treated as gouty arthritis. Within 2 weeks, he developed seropurulent discharge with osteomyelitic changes on imaging. He underwent debridement, and intraoperatively, there was destruction of most carpal bones. Histopathological examination revealed chronic granulomatous inflammation with abscess formation. Anti-TB medication was initiated, and he made a complete recovery with almost full range of wrist movement after 9 months of treatment. This case serves as a reminder that TB is a great mimicker, and a high index of suspicion is required to make a diagnosis of TB of the wrist. Early initiation of anti-TB is pivotal to prevent complications and deterioration of joint functions.
Databáze: Directory of Open Access Journals