Tuberculosis of Calcaneum - A Rare presentation

Tuberculosis of calcaneum is a rare entity. Osteoarticular tuberculosis of foot is uncommon and that of calcaneum is very rare. In children, diagnosis is often delayed as clinical presentation is non-specific and awareness is low due to its rare presentation. Also pediatric tuberculosis has traditionally received a lower priority than adult TB in National TB programmes.

8 yr old girl presented to OPD with swelling and dull aching pain over left heel. Radiograph of calcaneum showed small lytic puctate lesions in the calcaneum. Further investigations showed presence of multiple tuberculous bacilli. Anti-Kochs treatment was started immediately and patient was treated conservatively. Four drugs (HRZE) were prescribed for a period of 12 months. Radiographs at 2 years follow-up showed a healed lesion.

Rare and unusual locations of osteoarticular TB often pose a problem of differential diagnosis. Meticulous history and clinical examination helps in reaching the diagnosis. Start of AKT drugs as soon as reports show presence of tubercular bacilli plays a vital role in treatment as well as functional outcome of the patient.