A case of shoulder tuberculosis: Diagnostic challenges and insights

Abstract

This case report presents a middle-aged male patient who presented with worsening left shoulder pain and restricted movement. Clinical examination revealed moderate restriction of shoulder motion. Laboratory tests showed elevated ESR and lymphocytosis. MRI of the shoulder revealed bony abnormalities, synovial thickening, and joint effusion. Histological examination revealed granulomatous inflammation with caseation, and although culture results were negative, Mycobacterium tuberculosis was confirmed by Myco-3 PCR. The patient was initiated on antitubercular therapy and showed a positive response. Extrapulmonary tuberculosis, especially musculoskeletal involvement, can be difficult to diagnose, but MRI plays a crucial role in detecting bone tuberculosis. A multidrug treatment regimen is essential for managing osteoarticular tuberculosis.