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Tubercular Osteomyelitis of Cuboid
Naveen Jeyaraman1, Madhan Jeyaraman2, Sathish Muthu3
1Department of Orthopaedics, Atlas Hospitals, Tiruchirappalli, Tamil Nadu, India.
Journal of Orthopaedic Case Reports
|April 13, 2022
Summary
Tuberculosis affecting the foot is rare, often involving tarsal joints and the cuboid bone. Early diagnosis and multidrug chemotherapy are key for healing, with surgery limited to biopsy.
Area of Science:
- Orthopedics
- Infectious Diseases
- Radiology
Background:
- Tuberculosis (TB) of the foot is a rare clinical presentation, constituting less than 10% of osteoarticular TB cases.
- Tarsal joints and calcaneum are the most frequently affected sites, followed by other tarsal and metatarsal bones.
Observation:
- A 24-year-old female presented with an 8-month history of left foot pain and swelling.
- Radiographs showed osteolytic lesions in the metatarsals, cuneiforms, and cuboid, with soft tissue swelling and osteopenia.
- A trucut biopsy confirmed paucibacillary tuberculosis.
Findings:
- The patient received a 14-month course of anti-tuberculosis drugs (HRZE/HRE).
- Follow-up included monitoring inflammatory markers (ESR, CRP).
- Significant improvement in midtarsal joint movement was noted, with residual pain at terminal range of motion.
Implications:
- The cuboid bone is frequently involved in TB foot infections.
- A high index of suspicion is crucial for diagnosing this uncommon condition.
- Multidrug chemotherapy is sufficient for healing; surgical intervention should be reserved for biopsy purposes.
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