Abbaoui Siham, Hassan Hadi El, Belahcen Mohamed
Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco.
Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco.
Int J Surg Case Rep. 2022 Jun;95:107208. doi: 10.1016/j.ijscr.2022.107208. Epub 2022 May 18.
Osteoarticular tuberculosis represents 1 to 3% of all tuberculosis cases, the tuberculosis of the talus is a very rare form of osteoarticular tuberculosis. Its clinical and radiological features are not specific. In this study, we report a case of ankle tuberculosis involving the talus in a 5-year-old girl.
A 5 years old girl, was admitted for pain, swelling, and functional impairment of the left ankle, on the clinical examination, the patient manifested a painful oedematous ankle. The biological examination revealed a slight inflammatory syndrome, The X-ray of the ankle showed a lytic image of the posterior part of the talus with a cortical involvement. The biopsy revealed an epithelioid cell granuloma without any caseous necrosis. The medical management consisted of anti-tuberculosis multi-drug.
The tuberculosis of the talus is a very rare form of osteoarticular tuberculosis. In this study, we report a rare case of this localization of a 5-year-old girl. The non-specificity of symptoms is the main difficulty that causes a delay in diagnosis. Standard radiology, MRI, and biology were non-contributory. Bone biopsy and anatomopathological study led to the diagnosis of tuberculosis of the talus. The main aims of the surgical treatment are to take some sample for histological study, and to curette the diseased part in the bone followed by 6 to 9 months of anti-tuberculosis chemotherapy.
Tuberculosis of the talus is extremely rare, it deserves special attention especially in endemic areas.
骨关节结核占所有结核病例的1%至3%，距骨结核是骨关节结核中一种非常罕见的形式。其临床和放射学特征不具有特异性。在本研究中，我们报告了一例5岁女童踝关节结核累及距骨的病例。
一名5岁女童因左踝关节疼痛、肿胀和功能障碍入院。临床检查发现患者踝关节疼痛且有水肿。实验室检查显示有轻微炎症综合征，踝关节X线片显示距骨后部有骨质溶解影像，皮质受累。活检显示为上皮样细胞肉芽肿，无干酪样坏死。治疗方法为联合使用抗结核药物。
距骨结核是骨关节结核中一种非常罕见的形式。在本研究中，我们报告了一名5岁女童这种罕见部位的病例。症状不具有特异性是导致诊断延迟的主要困难。标准放射学、磁共振成像和实验室检查均无诊断价值。骨活检和组织病理学研究确诊为距骨结核。手术治疗的主要目的是获取一些样本进行组织学研究，并刮除骨内病变部位，随后进行6至9个月的抗结核化疗。
距骨结核极为罕见，尤其在流行地区值得特别关注。
