Pérez Carlos, Rojas Alvaro, Baudrand René, González Sergio, Fontboté Cristián
Departamento de Medicina, Anatomía Patológica y Departamento de Ortopedia y Traumatología, Hospital Clínico de la Pontificia Universidad Católica de Chile.
Rev Med Chil. 2002 Mar;130(3):319-21.
We report a previously healthy 51 years old woman with a one year history of pain in the left hip associated with a mass without fever or local inflammatory changes. Magnetic resonance imaging located the mass in the medial gluteal muscle. The pathological examination of the mass disclosed unspecific inflammatory changes. Due to worsening of pain, a left throchanteric bursitis was diagnosed two weeks later and a throchanteric bursectomy was performed, obtaining a second biopsy. Aerobic, anaerobic and fungal cultures were negative. Lowenstein-Jensen culture showed development of mycobacteria and a genetic probe confirmed the presence of Mycobacterium tuberculosis. The second biopsy also identified several granulomas with areas of caseation and the Ziehl-Nielsen stain was positive for acid fast bacilli. Osteoarticular tuberculosis, specially bursitis, should be suspected in the presence of chronic pain associated with swelling.