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Osteoarticular tuberculosis mimicking rheumatoid arthritis
Ong Ping Seung1, Wahinuddin Sulaiman
1Department of Rheumatology, Hospital Raja Permaisuri Bainun, Jalan Hospital, Perak, Malaysia. ongps@hotmail.com
Modern Rheumatology
|March 9, 2012
Summary
Tuberculosis arthritis typically affects large joints, but this case shows a rare presentation in small hand joints mimicking rheumatoid arthritis. Early diagnosis via synovial biopsy is crucial for effective antituberculosis treatment.
Area of Science:
- Rheumatology
- Infectious Diseases
- Orthopedics
Background:
- Tuberculosis (TB) is a significant global health challenge.
- Tuberculous arthritis usually presents as monoarthritis in weight-bearing joints.
- Differential diagnosis of inflammatory arthritis can be complex.
Observation:
- A rare case of osteoarticular tuberculosis involving multiple small joints of the hands is presented.
- The patient's presentation mimicked rheumatoid arthritis (RA), a common autoimmune condition.
- Magnetic resonance imaging revealed tenosynovitis, suggesting inflammation of the tendon sheath.
Findings:
- The patient initially received treatment for seronegative rheumatoid arthritis without improvement.
- Synovial biopsy was essential for accurate diagnosis of tuberculous arthritis.
- Complete recovery was achieved after a 1-year course of antituberculosis therapy.
Implications:
- Highlights the importance of considering osteoarticular tuberculosis in the differential diagnosis of inflammatory polyarthritis, even in small joints.
- Emphasizes the diagnostic value of synovial biopsy when initial treatments fail.
- Reinforces the efficacy of timely antituberculosis treatment for tuberculous arthritis.
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