Pereira Jeevan, Anoop S, Pettah George Joy
Department of Orthopaedics, Yenepoya Medical College Hospital, Deralakatte, Mangalore, Karnataka, India.
J Orthop Case Rep. 2017 Jan-Feb;7(1):87-90. doi: 10.13107/jocr.2250-0685.702.
Tuberculosis (TB) of the ankle is an uncommon presentation of extrapulmonary infection. The early diagnosis of TB arthritis of the ankle is difficult because of the uncommon site, the ability of TB to mimic other disorders and, all too common, lack of awareness of about this infection in ankle joint.
A 30-year-old male presented with a 1-year history of right ankle pain and swelling. He denied any history of recent infection but had had recurrent ankle pain that had been treated accordingly. When he visited our outpatient clinic, he was afebrile. The patient, despite a period of conservative treatment, presented with a localized painful fullness of the ankle. Magnetic resonance imaging helps for the diagnosis with variable specificity, but TB arthritis was diagnosed through a diagnostic arthroscopic procedure, and anti-TB therapy eventually eradicated the infection.
It is highly recommended that early biopsy and synovial fluid for polymerase chain reaction GeneXpert be performed in suspicious cases to confirm and treat accordingly.
踝关节结核是肺外感染的一种罕见表现形式。由于发病部位不常见、结核具有模仿其他病症的能力，且踝关节结核感染常被忽视，因此早期诊断踝关节结核性关节炎存在困难。
一名30岁男性，有1年的右踝关节疼痛和肿胀病史。他否认近期有任何感染史，但曾有复发性踝关节疼痛并接受过相应治疗。他前来我们门诊就诊时无发热症状。尽管经过一段时间的保守治疗，该患者仍表现为踝关节局限性疼痛性肿胀。磁共振成像有助于诊断，但其特异性各异，最终通过诊断性关节镜检查确诊为结核性关节炎，抗结核治疗最终根除了感染。
强烈建议对可疑病例尽早进行活检并采集滑液进行聚合酶链反应GeneXpert检测，以便进行确诊并相应治疗。
