Zamani Batool, Shayestehpour Mohammad
Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.
Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Am J Case Rep. 2019 Apr 15;20:522-524. doi: 10.12659/AJCR.915150.
BACKGROUND Skeletal involvement is an uncommon form of extrapulmonary Mycobacterium tuberculosis (MTB) that occurs in 1-3% of the patients. Knee joints may be affected in 8% of cases. CASE REPORT We reported a case of TB knee arthritis in a 35-year-old Afghan male who was referred to Kashan Rheumatology Clinic for pain and swelling in the left knee. The patient had no history of fever, chills, weight loss, or anorexia. His chest radiography was normal. The synovial fluid culture was positive for M. tuberculosis. Magnetic resonance imaging (MRI) of the left knee demonstrated a marked joint effusion, chondromalacia in the lateral patellar facet, and edema in the origin of the gastrocnemius muscle. The histopathologic examination revealed multiple granulomas with foci of necrosis. CONCLUSIONS This case demonstrated that clinicians should pay particular attention to the possibility of TB as the cause of chronic monoarthritis even when pulmonary involvement is not documented.
骨骼受累是肺外结核分枝杆菌（MTB）感染的一种罕见形式，发生率为1%至3%。膝关节受累的病例占8%。病例报告：我们报告了一例35岁阿富汗男性的结核性膝关节炎病例，该患者因左膝疼痛和肿胀被转诊至卡尚风湿病诊所。患者无发热、寒战、体重减轻或厌食史。胸部X线检查正常。滑膜液培养结核分枝杆菌呈阳性。左膝磁共振成像（MRI）显示明显的关节积液、髌外侧小面软骨软化以及腓肠肌起点水肿。组织病理学检查发现多个伴有坏死灶的肉芽肿。结论：该病例表明，即使没有记录到肺部受累，临床医生也应特别注意结核作为慢性单关节炎病因的可能性。
