Tuberculosis of and around the Ankle

Samuel, Sumant; Boopalan, P.R.J.V.C.; Alexander, Mathew; Ismavel, Ravichand; Varghese, Viju Daniel; Mathai, Thomas

doi:10.1053/j.jfas.2011.04.002

Cited by 30 publications

(49 citation statements)

References 19 publications

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“…The ankle and foot are rarely affected and account for only 1% of all TB infections. TB of foot and ankle was reported globally especially in developing countries [2][3][4]. There have been two case series of foot and ankle TB in Korea [5,6].…”

Section: Discussionmentioning

confidence: 99%

Tuberculous Osteomyelitis of the First Metatarsophalangeal Joint Misdiagnosed as Gouty Arthritis

et al. 2016

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A-43-year-old man visited our clinic due to pain and swelling of his left first metatarsophalangeal (MTP) joint since 6-months ago. He was diagnosed as gouty arthritis at private clinic and took hypouricemic agent, but he had progressive pain and swelling. There was swelling, erythema and tenderness and ulceration at base of the left first MTP joint. His laboratory results showed elevated C-reactive protein and normal serum uric acid level. The plain radiograph of foot showed bone destruction of left first MTP joint. MRI revealed joint space narrowing, soft tissue swelling and subchondral cyst. He underwent excisional biopsy and histology demonstrated chronic granulomatous inflammation with caseation necrosis. Tissue polymerase chain reaction for mycobacterium tuberculosis was positive. He was diagnosed as tuberculous osteomyelitis. He started on quadruple anti-tuberculous therapy and his symptom was improved. Early diagnosis and anti-tuberculosis therapy could lead to improve outcomes. (J Rheum Dis 2016;23:311-315)

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Section: Discussionmentioning

confidence: 99%

Tuberculous Osteomyelitis of the First Metatarsophalangeal Joint Misdiagnosed as Gouty Arthritis

et al. 2016

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“…The principal structure require reconstruction is the Tibio-talar joint [11], which often needs fusion, or the hind foot joints, which may also need to be stabilized occasionally.…”

Section: Historical Surgical Interventionsmentioning

confidence: 99%

Role of Surgery in Management of Osteo-Articular Tuberculosis of the Foot and Ankle

Dhillon¹,

Agashe²,

Patil³

2017

TOORTHJ

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Background:Tuberculosis of the foot and ankle still remains to be a significant problem, especially in the developing countries, and with an increase in incidence in immunosuppressed patients. Treatment is mainly medical using multidrug chemotherapy; surgical interventions range from biopsy, synovectomy and debridement, to joint preserving procedures like distraction in early cases, and arthrodesis of hindfoot joints and the ankle in advanced disease with joint destruction.Surgical Options: All procedures should be done after initiating appropriate medical management. The ankle is the commonest joint needing intervention, followed by the subtalar and talo-navicular joint. Forefoot TB limited to the bone rarely needs surgical intervention except when the infective focus is threatening to invade a joint. Articular disease can spread rapidly, so early diagnosis and treatment can influence the outcome. Surgical interventions may need to be modified in the presence of sinuses and active disease; fusions need compression, and implants have to be chosen wisely. External fixators are the commonest devices used for compression in active disease, but intramedullary nails better stabilize pantalar arthrodesis. Arthroscopy has become a valuable tool for visualizing the ankle and hindfoot joints, and is an excellent adjunct for arthrodesis by minimally invasive methods.Conclusion:Although Osteoarticular Tb involving the foot and ankle is largely managed with chemotherapy, specific indications for surgical intervention exist. Timely done procedures could limit joint destruction, or prevent spread to adjacent joints. Fusions are the commonest procedure for sequelae of disease or for correcting residual deformity.

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“…[1,2,22] Apparently, M. tuberculosis is able to persist in adipose tissue, suggesting that this may be a source of EP-TBC. [23] Joint infection is derived from adjacent osteomyelitis or by contact of synovial fluid with blood, where the cartilage undergoes necrosis. Vascularised bones such as the vertebrae are targets of microorganisms.…”

Section: Pathophysiologymentioning

confidence: 99%

Synovial tuberculosis of the hand: An ancient disease in an unusual localisation

Ramos

Cancian

Calcagnotto

et al. 2017

Indian J Plast Surg

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Background:Tuberculosis is the most prevalent infectious disease in the world. It is mainly caused by Mycobacterium tuberculosis. Osteoarticular tuberculosis represents 1%–3%. Tenosynovitis is the most common form of the disease in the hand.Aims:The aim of this study is to present an update of synovial tuberculosis.Materials and Methods:The authors present a literature review, the clinical and surgical management and case reports.Results:The outcomes were satisfactory and were not report complications.Conclusions:Early diagnosis, surgical transection of the transverse carpal ligament, debridement and complete excision of the infected synovium may be required, along with antituberculosis drugs. Knowledge of this disease in the hand can provide a better diagnosis and outcome.

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Tuberculosis of and around the Ankle

Cited by 30 publications

References 19 publications

Tuberculous Osteomyelitis of the First Metatarsophalangeal Joint Misdiagnosed as Gouty Arthritis

Tuberculous Osteomyelitis of the First Metatarsophalangeal Joint Misdiagnosed as Gouty Arthritis

Role of Surgery in Management of Osteo-Articular Tuberculosis of the Foot and Ankle

Synovial tuberculosis of the hand: An ancient disease in an unusual localisation

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