Hung Truong Nguyen Khanh, Duong Tran Binh, Binh Tran Phuoc, Tu Dao Thanh, Hau Huynh Phuoc, Tin Truong Trong, Thi Cao, Van Tuan Le
College of Medicine, Taipei Medical University, Taipei City, Taiwan.
Orthopedic and Trauma Department, ChoRay Hospital, Ho Chi Minh City, Vietnam.
Case Rep Orthop. 2020 Jan 9;2020:6369781. doi: 10.1155/2020/6369781. eCollection 2020.
In this report, we present the case of a 53-year-old man with rice body formation in the right knee caused by tuberculous arthritis (TB arthritis). The patient visited our hospital in January 2018 with a seven-month history of swelling and pain in the right knee. He had no previous history of tuberculosis, and the results of the routine laboratory tests were within normal limits; he also tested negative for rheumatoid factor. Magnetic resonance (MR) imaging revealed multiple rice bodies in the right knee, measuring 5-8 mm. He underwent an arthroscopic operation in the right knee in January 2018 and received antituberculosis polytherapy for 6 months. He was followed-up for more than 01 year. The patient regained good function of the operated knee with no evidence of recurrence during the last follow-up in February 2019. . The biggest challenge in diagnosing tuberculosis arthritis is the consideration of its possibility in the differential diagnosis, not only in endemic countries where tuberculosis is frequent. A high level of suspicion for TB should be maintained for every infection of the knee joint, particularly in the case of intra-articular rice bodies.
在本报告中，我们介绍了一例53岁男性因结核性关节炎导致右膝出现米粒体的病例。该患者于2018年1月因右膝肿胀疼痛7个月前来我院就诊。他既往无结核病史，常规实验室检查结果均在正常范围内；类风湿因子检测也呈阴性。磁共振成像显示右膝有多个米粒体，大小为5 - 8毫米。他于2018年1月接受了右膝关节镜手术，并接受了6个月的抗结核联合治疗。对其进行了1年多的随访。在2019年2月的最后一次随访中，患者手术膝关节功能恢复良好，无复发迹象。诊断结核性关节炎最大的挑战在于，不仅在结核病高发的流行国家，在鉴别诊断中都要考虑到其可能性。对于每一例膝关节感染，尤其是出现关节内米粒体的情况，都应高度怀疑结核。
