Yadav Amit Kumar, G S Prasanna Kumar, K S Akshay, Harsoor Abhishek, Mane Akash, Mishra Shaswat
Department of Orthopaedics, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra. India.
J Orthop Case Rep. 2020 Aug-Sep;10(5):24-26. doi: 10.13107/jocr.2020.v10.i05.1822.
Osteoarticular tuberculosis (TB) constitutes 1-3 % of cases and about 10% of osteoarticular TB affects the foot and ankle. In foot, TB calcaneus is the most commonly affected bone.
A 21-year-old male presented with pain, swelling in the right heel for 5 months and difficulty in walking for 2 months. Plain X-ray (axial) view of calcaneus showed a lytic lesion in calcaneus. Biopsy was done under local anaesthesia and histologic examination revealed a characteristic granuloma, caseous necrosis, and Langhans giant cells which confirmed our diagnosis. The patient was treated with anti-TB chemotherapy for 12 months. Radiographs at 18 months follow-up showed a healed lesion. At present, the patient is comfortable with no complaints.
TB calcaneus is rare condition and a high index of clinical suspicion along with imaging studies helps in diagnosis. Conservative management with anti-TB chemotherapy for adequate duration helps in complete resolution of the infection with good functional results.
骨关节结核占病例的1%-3%，约10%的骨关节结核累及足踝部。在足部，结核性跟骨炎是最常受累的骨骼。
一名21岁男性，右足跟疼痛、肿胀5个月，行走困难2个月。跟骨的X线平片（轴位）显示跟骨有溶骨性病变。在局部麻醉下进行活检，组织学检查发现特征性的肉芽肿、干酪样坏死和朗汉斯巨细胞，从而确诊。患者接受了12个月的抗结核化疗。18个月随访时的X线片显示病变已愈合。目前，患者情况良好，无不适主诉。
结核性跟骨炎是一种罕见疾病，高度的临床怀疑以及影像学检查有助于诊断。进行足够疗程的抗结核化疗的保守治疗有助于感染完全消退并取得良好的功能结果。
