Osteoarticular tuberculosis mimicking rheumatoid arthritis

Navigating Foot Tuberculosis in a Leprosy Survivor: A Case Managed Solely With Medical Strategies

We present a case report of a 66-year-old male patient with a known history of leprosy who presented with pain and swelling in his right foot for the past 1.5 years. Fine needle aspiration cytology (FNAC) revealed non-inflammatory exudate, and Mycobacterium tuberculosis (MTB) was identified in the sample by the cartridge-based nucleic acid amplification test (CBNAAT). The patient was managed conservatively with anti-Koch's treatment (AKT), and a follow-up was conducted for 12 months to monitor the treatment response and overall progress. This highlights the importance of early diagnosis and appropriate medical management, along with a long-term follow-up, among patients with ankle tuberculosis, to reduce the need for surgical intervention.

Tuberculous Arthritis of the Ankle Joint Mimicking Pigmented Villonodular Synovitis

Osteoarticular tuberculosis (TB) of the ankle joint is rare, and there is a delay in diagnosis in most cases. All patients with the disease complained of swelling and pain in the affected ankle. Ankle TB is a disorder that can be simply misdiagnosed. The delay in diagnosis may range from months up to years. All patients in this series had already been diagnosed with ankle TB by the time they visited our hospital. The current case was reported in a middle-aged male nurse with ankle pain, ulcer, and limited range of movement. The classical clinical manifestations of TB were absent on free chest radiography. Ulcer biopsy showed TB infection with no lymph nodes. Nonspecific inflammation was initially treated, but, subsequently, anti-TB treatment was useful.

Screening and identification of serum biomarkers of osteoarticular tuberculosis based on mass spectrometry

BACKGROUND

In view of the current difficulty of clinically diagnosing osteoarticular tuberculosis, our aim was to use mass spectrometry to establish diagnostic models and to screen and identify serum proteins which could serve as potential diagnostic biomarkers for early detection of osteoarticular tuberculosis.

METHODS

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was used to select an osteoarticular tuberculosis-specific serum peptide profile and establish diagnostic models. Further, liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to identify potential serum biomarkers that could be used for auxiliary diagnosis of osteoarticular tuberculosis, and then clinical serum samples were used to verify these biomarkers by enzyme-linked immunosorbent assay (ELISA).

RESULTS

We established four diagnostic models that can distinguish osteoarticular tuberculosis from rheumatoid arthritis, ankylosing spondylitis, osteoarticular infections, and healthy adults. The models were osteoarticular tuberculosis-rheumatoid arthritis, osteoarticular tuberculosis-ankylosing spondylitis, osteoarticular tuberculosis-osteoarticular infections, and osteoarticular tuberculosis-healthy adult, and their accuracy was 76.78%, 79.02%, 83.77%, and 88.16%, respectively. Next, we selected and identified 18 proteins, including complement factor H-related protein 1 (CFHR1) and complement factor H-related protein 2 (CFHR2), which were upregulated in the tuberculosis group only.

CONCLUSIONS

We successfully established four diagnostic models involving osteoarticular tuberculosis, rheumatoid arthritis, ankylosing spondylitis, osteoarticular infections, and healthy adults. Furthermore, we found that CFHR1 and CFHR2 may be two valuable auxiliary diagnostic indicators for osteoarticular tuberculosis. These results provide reference values for rapid and accurate diagnosis of osteoarticular tuberculosis.

Synovial tuberculosis of the hand: An ancient disease in an unusual localisation

Background

Tuberculosis is the most prevalent infectious disease in the world. It is mainly caused by Mycobacterium tuberculosis. Osteoarticular tuberculosis represents 1%-3%. Tenosynovitis is the most common form of the disease in the hand.

Aims

The aim of this study is to present an update of synovial tuberculosis.

Materials and Methods

The authors present a literature review, the clinical and surgical management and case reports.

Results

The outcomes were satisfactory and were not report complications.

Conclusions

Early diagnosis, surgical transection of the transverse carpal ligament, debridement and complete excision of the infected synovium may be required, along with antituberculosis drugs. Knowledge of this disease in the hand can provide a better diagnosis and outcome.

Extrapulmonary involvement in pediatric tuberculosis

Tuberculosis in childhood is clinically challenging, but it is a preventable and treatable disease. Risk factors depend on age and immunity status. The most common form of pediatric tuberculosis is pulmonary disease, which comprises more than half of the cases. Other forms make up the extrapulmonary tuberculosis that involves infection of the lymph nodes, central nervous system, gastrointestinal system, hepatobiliary tree, and renal and musculoskeletal systems. Knowledge of the imaging characteristics of pediatric tuberculosis provides clues to diagnosis. This article aims to review the imaging characteristics of common sites for extrapulmonary tuberculous involvement in children.

Tenosynovitis: a rare presentation of tuberculosis better known by hand surgeons than infectious diseases specialists

PURPOSE

Clinical presentation of tuberculosis is pleomorphic. Some forms are rare and better known by surgeons than infectious disease specialists.

METHODS

We describe a rare case of isolated chronic tenosynovitis of the wrist due to Mycobacterium tuberculosis in a 66-year-old man and review similar cases in the literature.

RESULTS

On literature search, only 23 other cases of tuberculous tenosynovitis were retrieved. Our case is similar, with an insidious classical presentation. The diagnosis was suggested at the surgical presentation by the presence of rice body masses.

CONCLUSION

The diagnosis of tuberculous tenosynovitis should be considered in chronic tenosynovitis. Functional prognosis may be committed without adequate treatment.