Tuberculosis of the Talus in a Child - A Rare Entity

A 10 year old boy presented with fever, local swelling around the ankle with tenderness and antalgic gait, without any antecedent trauma or discharging sinus. He had no evidence of pulmonary tuberculosis. Laboratory tests revealed signs of inflammation with normal Mantoux test and chest X-ray. An irregular lytic lesion of the talus was seen on the x-ray of the affected part. Ziehl Nelson staining of the aspirated fluid revealed acid-fast bacilli. Material obtained after curettage and bone grafting confirmed the diagnosis of tuberculosis. He was treated conservatively with splintage and 4 drug anti-tubercular chemotherapy for 18 months, without any residual tenderness or foot deformity at the final follow-up. This case has been reported because of its rarity and atypical clinical presentation.