Avhad Tanmay, Baharani Ankita, Singh Sushmita, Misal Ankush, Bengali Yash
Department of Orthopaedics, TNMC and B.Y.L Nair Charitable Hospital, Mumbai, Maharashtra, India.
Department of Radiology, TNMC and B.Y.L Nair Charitable Hospital, Mumbai, Maharashtra, India.
J Orthop Case Rep. 2024 Aug;14(8):66-70. doi: 10.13107/jocr.2024.v14.i08.4648.
Tuberculosis (TB) of the greater trochanter constitutes about 2% of musculoskeletal TB cases, often presenting with non-specific symptoms of localized pain, tenderness, and swelling, necessitating differentiation from other conditions like tumors. Bursal involvement results in the formation of a fluctuating mass. This case emphasizes the need for meticulous diagnostic evaluation in these cases due to their uncommon presentation and potential for inadequate assessment.
A 50-year-old male experienced hip pain and swelling after a trivial fall, leading to surgery for suspected abscess. Despite initial treatment, symptoms persisted which on further imaging suggested TB osteomyelitis that was confirmed on biopsy, prompting 18 months of anti-tubercular therapy. The patient showed significant improvement after a year, highlighting the importance of thorough evaluation and appropriate management in such cases.
This case emphasizes the rare occurrence of primary TB in the greater trochanter, advocating for precise diagnosis through advanced imaging. It also underscores the importance of comprehensive TB testing, particularly in extrapulmonary cases which are prevalent in developing nations, to improve treatment outcomes.
大转子结核约占肌肉骨骼系统结核病例的2%,常表现为局部疼痛、压痛和肿胀等非特异性症状,需要与肿瘤等其他疾病相鉴别。滑囊受累会导致形成波动性肿块。由于这些病例表现不常见且可能评估不足,本病例强调了对此类病例进行细致诊断评估的必要性。
一名50岁男性在轻微跌倒后出现髋部疼痛和肿胀,因怀疑脓肿而接受手术。尽管进行了初始治疗,但症状持续存在,进一步影像学检查提示结核性骨髓炎,活检确诊后,患者接受了18个月的抗结核治疗。一年后患者有显著改善,突出了在此类病例中进行全面评估和适当管理的重要性。
本病例强调了大转子原发性结核的罕见性,主张通过先进影像学进行精确诊断。它还强调了全面结核病检测的重要性,特别是在发展中国家普遍存在的肺外病例中,以改善治疗效果。