Samuel Sumant, Boopalan Palapattu R J V C, Alexander Manika, Ismavel Ravichand, Varghese Viju D, Mathai Thomas
Department of Orthopaedics (Unit III), Christian Medical College, Vellore, TN, India.
J Foot Ankle Surg. 2011 Jul-Aug;50(4):466-72. doi: 10.1053/j.jfas.2011.04.002. Epub 2011 May 25.
Osteoarticular tuberculosis of the ankle joint is rare, and diagnostic delays are common with this condition. The aim of our report is to highlight the varied clinical and radiologic presentation of this entity. We present a retrospective review of 16 patients with tuberculosis in and around the ankle joint who were surgically treated during a 6-year period. The incidence of ankle joint involvement in extraspinal osteoarticular tuberculosis was 15.7% in our unit. The most common presentation in our series was chronic septic arthritis, followed by periarticular osseous lytic lesion. Tuberculous synovitis, tenosynovits, and retrocalcaneal bursitis were also seen. Osteopenia, the hallmark of osteoarticular tuberculosis, might not be seen in all forms of tuberculosis affecting this joint. Chemotherapy remains the mainstay of treatment. Adjuvant surgery is often required to establish the diagnosis and in the treatment of patients with deformity and widespread destruction of articular cartilage owing to delayed presentation.
踝关节骨关节炎性结核较为罕见，这种病症常出现诊断延误。我们报告的目的是强调该病症多样的临床和放射学表现。我们对16例踝关节及其周围结核患者进行了回顾性研究，这些患者在6年期间接受了手术治疗。在我们科室，脊柱外骨关节炎性结核中踝关节受累的发生率为15.7%。我们系列病例中最常见的表现是慢性化脓性关节炎，其次是关节周围骨质溶解性病变。也可见结核性滑膜炎、腱鞘炎和跟腱后滑囊炎。骨质减少是骨关节炎性结核的标志，但在影响该关节的所有结核形式中可能并不都能见到。化疗仍然是主要的治疗方法。由于就诊延迟导致关节软骨畸形和广泛破坏的患者，通常需要辅助手术来明确诊断和进行治疗。
