Sreenivasan Ravi, Haq Rehan Ul
1 Clinical Fellow and Associate, Department of Orthopaedics, Delhi Institute of Trauma and Orthopaedics, Sant Parmanand Hospital, Civil Lines, New Delhi, India.
2 Professor, Department of Orthopaedics, University College of Medical Sciences & GTB Hospital, University of Delhi, New Delhi, India.
Trop Doct. 2017 Apr;47(2):153-158. doi: 10.1177/0049475516688785. Epub 2017 Jan 23.
A 30-year-old woman presented to our outpatient department with complaints of pain and swelling in bilateral infrapatellar regions and a discharging sinus in the right knee over the duration of one year. Radiographs showed lytic regions in bilateral patellae. Samples sent from material curetted from sinus yielded no organism but histopathology reported granulomatous inflammation. Following a fresh magnetic resonance imaging (MRI) scan that revealed the infrapatellar pad of fat communicating with the patellar lesions, an exploration and evacuation was done. Material sent revealed epithelioid cell granulomas with caseous necrosis consistent with tuberculosis (TB). The patient was put on first line anti-tubercular treatment (ATT) and has responded favourably with healing of sinus and patellar lesions. Bilateral infrapatellar bursitis is not rare. However patellar TB as a cause for OMIT is not a common diagnosis. A bilateral patellar involvement has not been reported in literature to the best of our knowledge.
