Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Although osteoarticular tuberculosis is usually presented as monoarthritis of the large, weight-bearing joints (predominantly hip, knee or ankle joint), or in the form of spinal disease, it is rarely seen as oligoarthritis. In this article, we present case history of a female patient with tuberculous oligoarthritis of the right talocrural joint and left talocalcaneal joint. A 77-year-old female patient was admitted to our department due to the symptoms of painful and swollen right talocrural joint and left talocalcaneal joint accompanied with fever, general weakness and night sweating. Laboratory findings, including erythrocyte sedimentation rate, whole blood count, liver and kidney functional tests showed no significant changes. Plain x-rays and magnetic resonance imaging of the affected joints showed demineralization, significant narrowing of joint space, erosions of articular surfaces, numerous calcifications, and ankylosis of both right talocrural and left talocalcaneal joint. Synovial biopsy confirmed the diagnosis of tuberculous arthritis. Our patient underwent triple tuberculostatic therapy with rifampicin, isoniazid and pyrazinamide, which resulted in the resolution of arthritis.Iako se koštano-zglobna tuberkuloza najčešće prezentira kao monoartritis velikih zglobova koji prenose težinu (osobito
kukovi, koljena ili gležanj) ili zahvaćenošću kralježnice, rijetko se javlja u obliku oligoartritisa. U ovom članku daje se
prikaz bolesnice s tuberkuloznim oligoartritisom desnog talokruralnog zgloba i lijevog talokalkanealnog zgloba. Sedamdeset- sedmogodišnja bolesnica je primljena u našu Kliniku zbog bolova i otekline desnog talokruralnog zgloba i lijevog talokalkanealnog zgloba popraćenog tresavicom, općom slabošću i noćnim znojenjem. Laboratorijski nalazi, uključujući sedimentaciju eritrocita, kompletnu krvnu sliku, jetrene i bubrežne testove, nisu pokazali nikakva odstupanja. Konvencionalni rendgenogrami i magnetska rezonanca zahvaćenih zglobova pokazali su demineralizaciju, značajno suženje zglobnog prostora, erozivne promjene zglobnih površina, brojne kalcifikate i ankilozu desnog talokruralnog zgloba i lijevog talokalkanealnog zgloba. Biopsija sinovije je potvrdila dijagnozu tuberkuloznog artritisa. Kod bolesnice je provedena trojna tuberkulostatska terapija rifampicinom, izonijazidom i pirazinamidom koja je dovela do povlačenja artritisa
