Tuberculosis of clavicle is one of the rarely reported pathology of skeletal tuberculosis in the literature. It is difficult to diagnose because other conditions of clavicle also presents with same confusing picture, which can lead to delay in proper diagnosis and treatment. Our case is a young adolescent female presenting with complaints of mild pain and swelling in mid clavicular region for the last six month. She was diagnosed as case of mid clavicular tuberculosis and she was managed with anti-tubercular chemotherapy.
Isolated tuberculosis of cuneiform is rare in literature. Diagnosis of tuberculosis of cuneiform remains a dilemma because of its rarity in the lower limb. Chance of misdiagnosis and delay in diagnosis may add to morbidity. Presumptive diagnosis can be made on the basis of X-ray, MRI, histopathology of the pathological tissue, which reveals granulomatous inflammation with or without caseation. Here we are reporting a case of 15 year old girl with swelling and pain over a mid foot diagnosed as tuberculosis of cuneiform on subsequent X-ray, MRI and biopsy.
Macrodystrophia lipomatosa is a rare presentation and only few cases are reported in scientific literature. We report a case of Macrodystrophia lipomatosa in a 7 year young girl from a tertiary care hospital Mumbai. Case presentation: A 7 year old female was presented to outpatient department with progressive enlargement of right lower limb with increase in size of right great toe since birth. On clinical examination there was non tender fluctuant soft tissue swelling with good functional limb. Scannogram showed reduction of the medial compartment of right knee joint and the right lower limb length was slightly longer compared to the left side with presence of soft tissue swelling on medial distal thigh and knee region. MRI showed un-encapsulated subcutaneous fatty tissue involving the entire right lower limb along its medial aspect up to the great toe with fatty infiltration of the vastus medialis muscle suggestive of macrodystrophia lipomatosa. Arterial and venous colour Doppler study of right lower limb was normal. Conclusion: Macrodystrophia lipomatosa is a rare congenital, non hereditary condition with localized macrodactyly and proliferation of mesenchymal element and marked increase in fibroadipose tissue. X-ray and MRI are investigation of choice. Doppler study shows normal vascularity.
Tuberculous dactylitis (TD) is an uncommon presentation. It is also known as spina ventosa. Mycobacterium tuberculosis is the causative agent responsible for Tuberculosis. We here present a case of a young adolescent female presenting with complaints of pain and swelling in middle finger region for the last seven month. She was diagnosed as case of tubercular dactylitis and was managed surgically along with anti-tubercular chemotherapy.
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