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Isolated tuberculosis of the talus bone
Mohammad-Hossein Ebrahimzadeh1, Eghbal Sadri
1Department of Orthopedic Surgery, Mashhad University of Medical Sciences, Mashhad, Iran. Persia806@yahoo.com
Archives of Iranian Medicine
|May 3, 2006
Summary
Tuberculosis can affect the ankle bone, causing swelling and pain in children. Early diagnosis through biopsy and treatment with surgery and chemotherapy led to a good outcome for this young patient.
Area of Science:
- Orthopedic Surgery
- Pediatric Infectious Diseases
- Radiology
Background:
- Tuberculosis (TB) is a significant global health issue, primarily affecting the lungs but can manifest in bones and joints.
- Osteoarticular tuberculosis is rare in children and often presents with non-specific symptoms, delaying diagnosis.
Observation:
- A 7-year-old boy presented with a 3-month history of left ankle swelling and pain.
- Initial investigations revealed an elevated erythrocyte sedimentation rate and an extensive lytic lesion of the talus on X-ray.
- A negative Mantoux skin test and normal chest X-ray complicated the initial diagnostic process.
Findings:
- Histological examination of a talus biopsy confirmed granuloma and caseating necrosis, indicative of tuberculosis.
- The patient underwent talectomy (surgical removal of the talus bone).
- A 6-month course of antituberculous chemotherapy was administered post-surgery.
Implications:
- This case highlights the importance of considering tuberculosis in pediatric patients with bone lesions, even with negative skin tests.
- Aggressive surgical and chemotherapeutic management can achieve favorable clinical outcomes in talar tuberculosis.
- Early and accurate diagnosis is crucial to prevent long-term morbidity associated with osteoarticular tuberculosis.