"An Atypical Presentation of Tuberculosis Elbow" - A Case Report.

Abstract

Introduction: Elbow joint is the most common affliction in upper limb tuberculosis (TB). A review of literature shows varying clinical presentations of TB in the elbow, with and without detectable primary foci.

Case report: We report a rare case of post-traumatic reactivation of latent TB of elbow which mimicked septic arthritis, in a healthy adult who suffered an elbow contusion injury following an road traffic accident. It was misdiagnosed as septic arthritis elsewhere and was going non-responsive to broad-spectrum antibiotics. At our center, we suspected TB and magnetic resonance imaging done showed joint destruction and fibrous ankylosis. He underwent joint debridement with removal of fibrous tissue and synovectomy. The synovial biopsy and polymerase chain reaction were consistent with TB. At 1-year follow-up on anti-tuberculosis treatment, he was relatively pain free and regained functional range of movement.

Conclusion: Post-traumatic reactivation of TB in joints, though a rare entity, should be kept in mind in patients who are non-responsive to routine antibiotics, especially in endemic areas. Early and accurate diagnosis prevents progression to articular destruction and fibrous ankylosis.Level of Evidence: V.