Tayfur Öykü, Kılıç Levent, Karadağ Ömer, Akdoğan Ali, Kerimoğlu Ülkü, Uzun Ömrüm
Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Department of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Eur J Rheumatol. 2015 Mar;2(1):31-32. doi: 10.5152/eurjrheumatol.2015.0069. Epub 2015 Mar 1.
Tuberculous trochanteric bursitis (TTB) is a rare condition that accounts for 1% of musculoskeletal tuberculosis cases. Extrapulmonary TB is usually diagnosed late because of reduced diagnostic suspicion, particularly in the absence of signs of systemic infection. Herein, we report a case of right hip pain that was misdiagnosed as ankylosing spondylitis. The patient had a history of inflammatory back pain with morning stiffness. However, HLA-B27 was negative. Sacroiliac magnetic resonance imaging (MRI) revealed a giant multiloculated collection (27×16×10 cm). Percutaneous drainage was performed and was observed in fluid culture. The patient was treated by drainage along with antituberculosis therapy. After 1 year of antituberculosis therapy, control MRI revealed total resolution of the large fluid collection. It is important to emphasize that fever or general symptoms are absent in patients with TTB, as observed in the present case. In endemic countries, TTB should be kept in mind in the differential diagnosis of a patient presenting with chronic hip pain without fever, weight loss, and constitutional symptoms.
结核性转子滑囊炎（TTB）是一种罕见疾病，占肌肉骨骼结核病例的1%。肺外结核通常因诊断怀疑度降低而诊断较晚，尤其是在没有全身感染迹象的情况下。在此，我们报告一例右髋疼痛被误诊为强直性脊柱炎的病例。该患者有炎性背痛伴晨僵病史。然而，HLA - B27呈阴性。骶髂关节磁共振成像（MRI）显示一个巨大的多房性积液（27×16×10 cm）。进行了经皮引流，并在液体培养中观察到相关情况。该患者接受了引流及抗结核治疗。抗结核治疗1年后，对照MRI显示大的积液完全消退。如本病例所示，强调TTB患者无发热或全身症状很重要。在流行国家，对于有慢性髋部疼痛但无发热、体重减轻和全身症状的患者进行鉴别诊断时应考虑TTB。
