Tuberculous arthritis of the ankle. Case report

Abstract

Introduction: tuberculosis of the talus is not a frequent pathology, for this reason delays in diagnosis and confusion with other processes are highly frequent. Early diagnosis and proper treatment are necessary to avoid joint destruction and skeletal deformity.

Clinical case: It is a case of a 45-years-old male patient presented with a 5-years history of trauma to the right ankle, a family history of pulmonary tuberculosis, who went to the emergency room because of painful swelling and skin fistula in his right ankle, as well as fever, sweating and general malaise. The x-ray and Computed Tomography (CT) of the foot show an osteolytic lesion of the right talus. The patient is treated with antibiotics for staphylococcus without improving symptoms. The wound was punctured, taking samples with a negative result in Ziehl-Neelsen staining, aerobic and anaerobic cultures and cytology. The surgical approach to the lesion with drainage is decided. The histopathological study revealed the presence of necrotizing granulomas. The clinical and radiological evolution was good after 9 months of the treatment for tuberculosis.

Conclusion: this case shows us that in a chronic inflammatory lesion of the ankle the diagnosis of tuberculosis must be ruled out, especially in patients from endemic regions of tuberculosis.