Isolated calcaneal tuberculous osteomyelitis in a 13-year female: a diagnostic dilemma: rare case report and review of literature
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20231197Keywords:
Calcaneal, Foot-ankle, Infection, Osteolytic, TuberculosisAbstract
Foot and ankle involvement in osteoarticular tuberculosis is uncommon and isolated calcaneal tubercular osteomyelitis of foot bones sparing nearby joints with an osteolytic defect is even more rare. Worsening of the disease can occur over a time involving nearby joints and small bones if diagnostic and therapeutic phase are delayed. We present a retrospective study of osteolytic variety of foot calcaneal bone tuberculosis. We present a case report of 13-year female with isolated osteolytic variety of calcaneal tuberculous osteomyelitis to highlight the clinical, radiological features and management challenges of the condition. Biopsy was done to confirm tissue diagnosis based on Gene Xpert, AFB staining, MGIT culture, and histopathology. Surgical intervention was done in form of debridement and sinus tract removal as a diagnostic and therapeutic purpose to prevent further involvement of a nearby joints and small bone with cystic destruction. Isolated calcaneal tubercular osteomyelitis cases are still found to be seen in our environment though considered a rare. When tuberculous pathology is limited to the isolated calcaneal bone sparing the other joints, the prognosis is better than in osteoarticular disease, as there is less deformity, and hence, less residual pain and disability.
References
Sorrel E, Sorrel-Dejerine (mme): Tuberculose osseuse et osteoarticulare. Mason, Paris, 1932.
Deberye J, Derrion M. Tuberculose osteo-articulare. Encyclopedie medico-chirurgicale: appareil locomoteur. Paris. 1969;14(184)-10-3.
Silva JF. A review of skeletal Tuberculosis at the University Hospital Kuala Lumpur. Int Ortho. 1980;4:79-91.
Martini M, Adjrad A. Tuberculosis of Ankle and Foot Joints. In Martini M , Ed, Tuberculosis of the bones and joints, Springer Verlag, Heidelberg. 1988: 138-148.
Tuli SM. Tuberculosis of the skeletal system. 2nd edition, N Delhi, Jaypee Bros. 1997.
American Thoracic Society. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med. 2000;161:1376-95.
Agarwal N, Jain SK; Tuberculous osteits of skull: A case report. Indian J Tuberc. 2009;(49):105.
Gupta KB, Manchanda M, Yadav SPS, Mittal A; Tubercular osteomyelitis of mandible. Indian J Tuberc. 2005;(52):147-50.
Dhillon MS, Sharma S, Gill SS, Nagi ON: Tuberculosis of Bones and joints of the foot: An analysis. Foot Ankle. 1993;14(9):505-13.
Dhillon MS, Nagi ON. Tuberculosis of the foot and ankle. Clin Orthop Relat Res. 2002;398:107-13.
Dhillon MS, Aggarwal S, Prabhakar S, Bachhal V. Tuberculosis of the foot: an osteolytic variety. Indian J Orthop. 2012;46:206-11.
Dhillon MS, Singh P, Sharma R, Gill SS, Nagi ON. Tuberculous osteomyelitis of the cuboid: a report of four cases. J Foot Ankle Surg, 2000;39(5):329-35.
Mittal R, Gupta V, Rastogi S. Tuberculosis of the foot. J Bone Joint Surg. 1999;81:997-1000.
Evanchick CC, Davis DE, Harrington TM. Tuberculosis of peripheral joints; an often missed diagnosis. J Rheumatol. 1986;13;187-9.
Ferrer MF, Torres LG, Ramírez OA, Zarzuelo MR, Del Prado González N. Tuberculosis of the spine. A systematic review of case series. Int Orthop. 2011;10:1414-4.
