Jemaa Mohamed Ben, Zribi Wassim, Elleuch Emna, Bouaziz Wajdi, Abid Ameur, Yaich Soumaya, Aoui Mourad, Ayedi Kamel, Jemaa Mounir Ben, Zribi Mohamed, Keskes Hassib
Service de Chirurgie Orthopédique et Traumatologique, CHU Habib Bourguiba de Sfax,Tunisie.
Service des Maladies Infectieuses, CHU Hédi Chaker de Sfax, Tunisie.
Pan Afr Med J. 2018 Jun 27;30:182. doi: 10.11604/pamj.2018.30.182.12557. eCollection 2018.
Tuberculosis of the shoulder is rare. It encompasses all articular and periarticular tuberculouses of the shoulder. Its insidious evolution, mimicking inflammatory and degenerative diseases, reflects the frequency of its diagnostic delay. We report a rare case of tuberculous bursitis of the shoulder in a woman living in rural areas, with renal insufficiency and treated for peritoneal TB and psoas. The anamnesis revealed signs of tuberculous impregnation. Clinical examination showed painful swelling of the shoulder associated with stiffness. MRI of the shoulder objectified infectious bursal disease. Its tuberculous origin was confirmed by the histological examination of ultrasound-guided synovial biopsy. The patient underwent TB treatment with good outcome. At 9-year follow-up, the patient had satisfactory articular function with no recurrence of infectious disease.
肩部结核较为罕见。它涵盖了肩部所有关节及关节周围的结核病变。其隐匿性发展过程，类似炎症性和退行性疾病，这反映出其诊断延迟的常见性。我们报告了一例居住在农村地区、患有肾功能不全且正在接受腹膜结核和腰大肌结核治疗的女性肩部结核性滑囊炎罕见病例。病史显示有结核感染迹象。临床检查发现肩部疼痛性肿胀并伴有僵硬。肩部磁共振成像（MRI）显示为感染性滑囊疾病。经超声引导下滑膜活检的组织学检查证实了其结核起源。该患者接受了抗结核治疗，效果良好。在9年的随访中，患者关节功能良好，传染病无复发。
