Related Experiment Videos
Musculoskeletal Tuberculous Arthritis Mimicking Septic Arthritis
Aparna Abhirami Rathnam1, Harleen Sidhu1, Thanushiree Sivalingam1
1Department of Medicine, Icahn School of Medicine at Mount Sinai, NYC Health + Hospitals / Elmhurst.
Journal of Investigative Medicine High Impact Case Reports
|August 4, 2026
Summary
A young woman with persistent fevers was diagnosed with miliary tuberculosis affecting her hip and ankle. Early septic arthritis diagnosis was complicated by negative cultures, highlighting the need for further investigation.
Area of Science:
- Infectious Diseases
- Orthopedics
- Radiology
Background:
- A young woman presented with acute left hip pain, initially suspected as septic arthritis.
- She had a prior history of right ankle pain treated as septic arthritis.
Purpose of the Study:
- To investigate the cause of persistent fevers and joint pain in a patient with initially negative cultures for septic arthritis.
- To highlight the diagnostic challenges and eventual identification of miliary tuberculosis.
Main Methods:
- Clinical presentation and imaging of hip and ankle joints.
- Analysis of synovial fluid from hip and ankle washout.
- Acid-fast bacilli (AFB) testing for Mycobacterium tuberculosis.
Main Results:
- Initial imaging suggested septic arthritis in both left hip and right ankle.
- Gram stain and bacterial cultures from joint washout were negative.
- Further imaging revealed miliary tuberculosis; AFB testing confirmed Mycobacterium tuberculosis in right ankle fluid.
Conclusions:
- Miliary tuberculosis can mimic septic arthritis, presenting a diagnostic challenge.
- Negative initial cultures do not exclude tuberculous arthritis.
- Prompt diagnosis and appropriate anti-tuberculosis treatment are crucial.
Related Concept Videos
01:31Pulmonary Tuberculosis III
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
01:28Pulmonary Tuberculosis II
Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
01:26Pulmonary Tuberculosis IV
Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
01:23Tuberculosis
Tuberculosis (TB) remains a significant global health concern, primarily targeting the lungs and spreading through airborne transmission. Infection begins when aerosolized droplet nuclei, expelled by an individual with active TB, are inhaled by another person. These microscopic particles carry Mycobacterium tuberculosis, the causative agent of TB. Upon reaching the alveoli, the bacilli are engulfed by alveolar macrophages. However, due to their specialized lipid-rich cell wall, these pathogens...
01:14Atypical Pneumonia
Atypical pneumonia, often caused by Mycoplasma pneumoniae, is a form of pulmonary infection that differs from the classical presentation of bacterial pneumonia in both its cause and clinical symptoms. Mycoplasma pneumoniae is a pleomorphic bacterium notable for its lack of a rigid cell wall. This structural characteristic imparts resistance to beta-lactam antibiotics and significantly influences the bacterium’s behavior within the human host.Other pathogens responsible for the disease include...