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Tuberculous synovitis of the knee in a 65-year-old man
Laura D Ciobanu1, Dragica P Pesut
1University of Medicine and Pharmacy Gr T Popa Iasi, Clinical Hospital of Rehabilitation Iasi, Romania.
Introduction:
Tuberculous (TB) synovitis is a rare, treatable, potentially lethal form of extrapulmonary TB resulting from massive lymphohematogenous dissemination of Mycobacterium tuberculosis (M. tuberculosis). We presented a case of TB synovitis of the knee in a Caucasian HIV-negative man from Romania, a high TB incidence country.
Case Report:
A 65-year old man presented with cough, high fever, mild wheezing, and swelling of the left knee. Chest radiography was normal. Sputum smears were Acid Fast Bacilli negative and Lowenstein-Jensen (L-J) culture negative for M. tuberculosis. Tuberculin skin test was negative. Respiratory symptoms disappeared in a week under antibiotics. Positive L-J cultures of knee punctation and favourable treatment outcome following standardized antituberculous treatment regimen confirmed the diagnosis of specific synovitis, which was also demonstrated by Magnetic Resonance Imaging (MRI).
Conclusion:
Tuberculous synovitis is important differencial diagnosis in patients with arthropathies and risk factors for TB in all the countries and all patients' ages even when tuberculin skin test is negative.
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