Polyarticular tuberculosis in a young boy: a rare presentation.

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Pediatric Rheumatology

Background:

• Tuberculosis (TB) typically affects the lungs but can manifest in other organs.
• Polyarticular involvement, especially in large joints like the hip and knee, is uncommon.
• Diagnosing extrapulmonary TB can be challenging due to non-specific symptoms.

Observation:

• A young boy presented with joint pain and swelling affecting both hips and knees.
• Initial investigations did not reveal evidence of pulmonary tuberculosis or disseminated disease.
• The clinical presentation mimicked other forms of juvenile arthritis.

Findings:

• Cultures and histopathology confirmed Mycobacterium tuberculosis infection in the affected joints.
• This case represents a rare instance of polyarticular joint tuberculosis.
• The absence of typical TB symptoms complicated the initial diagnosis.

Implications:

• Highlights the importance of considering extrapulmonary tuberculosis in pediatric patients with polyarticular joint involvement, even without classic TB symptoms.
• Suggests the need for a high index of suspicion and thorough diagnostic workup for joint tuberculosis in endemic and non-endemic areas.
• Contributes to the understanding of atypical presentations of tuberculosis in children.