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Ulnar bone tuberculosis in children: Case report and literature review
Qineng Mo1, Xiaohua Wei1, Xiansheng Xia1
1Pediatric Orthopedics, Dongguan Children's Hospital Affiliated to Guangdong Medical University, Dongguan City, China.
Insights
Pediatric ulnar tuberculosis, though rare, can cause significant bone destruction. Early diagnosis and treatment, including surgery and medication, are crucial for bone recovery and function.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
- Skeletal Tuberculosis
Background:
- Tuberculosis affecting long bones in children is uncommon, with ulnar involvement being particularly rare.
- Early diagnosis of skeletal tuberculosis presents considerable challenges, often mimicking other conditions.
- This case highlights a rare presentation of pediatric ulnar tuberculosis.
Purpose of the Study:
- To report a case of pediatric ulnar tuberculosis.
- To review diagnostic and therapeutic strategies for this condition.
- To provide insights for managing similar rare pediatric bone infections.
Main Methods:
- A 2-year-old child presented with extensive ulnar bone destruction and expansion.
- Differential diagnoses included malignant bone tumors and irreversible deformation.
- Diagnosis was confirmed as tuberculosis of the ulna.
Main Results:
- Surgical debridement of affected ulnar tissue was performed.
- The patient received a course of anti-tuberculosis medication.
- Post-treatment, ulnar morphology and bone structure normalized, resolving destruction and expansion.
Conclusions:
- Extensive long bone destruction in children warrants consideration of tuberculosis, even without classic systemic symptoms.
- Prompt diagnosis and appropriate anti-tuberculosis therapy are vital for favorable outcomes.
- This case underscores the importance of considering tuberculosis in pediatric bone lesions with atypical presentations.
Rationale:
Tuberculosis of the long tubular bones in children's extremities is infrequent, particularly in the ulna. Early diagnosis poses significant challenges. This report presents a case involving a 2-year-old child with tuberculosis of the ulnar bone, accompanied by a comprehensive review of pertinent literature. The purpose of this study is to share diagnostic and therapeutic experiences and provide potentially valuable insights.
Patient Concerns:
In this case, the patient exhibited complete destruction and expansion of the ulnar bone, resulting in a forearm size considerably greater than normal. Concerns were raised about the irreversible deformation of the ulna, the potential for a malignant bone tumor, and its impact on forearm function, potentially endangering the patient's life.
Diagnoses:
The diagnosis was confirmed as tuberculosis of the ulnar bone.
Interventions:
The patient underwent surgery to remove the affected ulnar tissue and received anti-tuberculosis medication.
Outcomes:
Subsequent to treatment, the destruction and expansion of the ulnar bone resolved, with the return of normal ulnar morphology and bone structure.
Lessons:
Even in the absence of typical symptoms like fever, weight loss, and loss of appetite, extensive destruction and expansion of a long tubular bone should prompt vigilant consideration of bone tuberculosis.
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