Anand A, Sood L K
Department of Orthopedics, Lady Hardinge Medical College and Associated Hospitals, New Delhi-110001, India.
Med J Malaysia. 2002 Sep;57(3):371-3.
This case has been reported because of its rarity and atypical clinical presentation. An 8-year-old boy presented with a gradually increasing swelling localised on the antero-medial aspect of the foot haemogram, erythrocyte sedimentation rate (ESR), Mantoux and X-ray chest were normal. An irregular lytic lesion of the talus was seen on the x-ray of the affected part. Ziehl Nelson staining of the aspirated fluid revealed acid-fast bacilli. Material obtained after curettage and bone grafting was sent for histopathological examination which confirmed the diagnosis of tuberculosis. Post operatively a below knee cast was given for 12 weeks and anti tubercular treatment was given for 20 months. At the end of the treatment patient had full and painless motion at the ankle and subtalar joint. The lytic lesion had healed on X-ray.
报道该病例是因其罕见且临床表现不典型。一名8岁男孩因足部前内侧逐渐增大的肿胀前来就诊,血常规、红细胞沉降率(ESR)、结核菌素试验及胸部X线检查均正常。患部X线显示距骨有一不规则溶骨性病变。抽吸液的齐-尼氏染色显示抗酸杆菌。刮除术和骨移植术后所取材料送去做组织病理学检查,确诊为结核病。术后给予膝下石膏固定12周,并进行抗结核治疗20个月。治疗结束时,患者踝关节和距下关节活动自如且无疼痛。X线显示溶骨性病变已愈合。