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Cases Journal

, 2:6859

First Online: 07 July 2009Received: 24 March 2009Accepted: 11 June 2009DOI: 10.4076-1757-1626-2-6859

Cite this article as: Flint, J.D. & Saravana, S. Cases Journal 2009 2: 6859. doi:10.4076-1757-1626-2-6859


IntroductionThe prevalence of tuberculosis is increasing and musculoskeletal tuberculosis, although currently rare, may become an important problem.

Case presentationWe report the case of a 20-year-old Somalian man, who presented with an inversion injury to his ankle. When further history was taken, it transpired that he had sustained trauma to his ankle in Somalia 4 years previously, complicated by a non-healing wound. His foot pain and swelling had been present ever since. Diagnosis of tuberculosis was made by bone biopsy, histology of which demonstrated caseating granulomas. Tissue culture yielded growth of tuberculous bacilli. The patient made a full recovery on anti-tuberculous treatment.

ConclusionMusculoskeletal tuberculosis can be difficult to diagnose as only about one third of patients have respiratory symptoms. Synovial fluid aspirate is relatively unlikely to lead to definitive diagnosis, and a bone biopsy should always be taken for culture and histological examination.

AbbreviationsMRIMagnetic resonance imaging


ZNZeil Neelson stain.

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Autor: Julia D Flint - Shanmugam Saravana


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