Open AccessTuberculosis of lunate as an isolated intraosseous osteolytic lesion in an adult: a diagnostic challenge
Author(s) -
Prasoon Kumar,
Sameer Aggarwal,
Rajesh Kumar Rajnish,
Saurabh Agarwal
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-229597
Subject(s) - medicine , tuberculosis , constitutional symptoms , weight loss , lunate , histopathology , surgery , presentation (obstetrics) , rare disease , wrist , dermatology , disease , pathology , obesity
In an endemic zone of tuberculosis (TB), osseous involvement is a relatively common presentation. Spine and long bones are the the most common nidus of TB. Smaller bones and joints are relatively less involved. Thorough clinical examination and history of typical constitutional symptoms like weight loss, fever and loss of appetite are the diagnostic aids for initiating early treatment. Wrist and hand involvement is a rare occurrence and often presents atypically without any obvious symptoms or signs. This results in delayed diagnosis and worse outcome. TB of lunate without articular involvement is a very rare subset and we present such an isolated case of TB involving the lunate, without any typical symptoms, with the patient complaining of vague pain without any restriction of joint mobility. TB was diagnosed with the aid of radiology, haematology and histopathology. 18 months of multidrug antitubercular treatment was given, to which the patient responded well.