Tuberculous osteomyelitis of the wrist presenting as a monoarthritis syndrome

Fracture of the Distal Radius by Tuberculous Osteomyelitis: A Case Report and Review of Literature

We report a 94-year-old patient with a fractured radius that was being managed conservatively. At 2 months, an abscess was observed overlying the fracture site. An MRI scan was done and samples obtained for microbiological and pathological analyses. The patient was diagnosed with tuberculous osteomyelitis. Surgical debridement of the fracture site was performed, and the bone defect was filled with bone cement impregnated with gentamicin and rifampicin. Anti-tuberculosis therapy was administered for 9 months and the patient made an uneventful recovery. Early diagnosis and correct medical treatment depend on sound evidence of tuberculous osteomyelitis. Surgical debridement is essential if abscesses are present in the bone. Level of Evidence: Level V (Therapeutic).

Uncommon Association of Tuberculous Dactylitis and Cutaneous Polyarteritis Nodosa in a Hemodialysis Patient

Tuberculous dactylitis, defined as the infection of the metacarpals, metatarsals, or phalanges of the hands or feet, is an uncommon manifestation of extrapulmonary tuberculosis. It is mainly seen in pediatric populations, especially those less than 6 years old. Here, we present a case of tuberculous dactylitis in an elderly patient with end-stage renal disease on hemodialysis. Moreover, our patient also developed generalized nodular lesions during hospitalization. Skin biopsy was consistent with cutaneous polyarteritis nodosa, which is a rare association with tuberculosis. She was treated with antituberculous drugs with significant improvement in both cutaneous nodules and dactylitic lesions.