Case Report: A Case of Tuberculous Osteomyelitis of Proximal Tibia Mimicking Infective Osteomyelitis Clinically in an Adolescent Child

Background: Tuberculosis osteomyelitis is rarely seen in the diaphyseal bones. Late diagnosis of the disease causes bone destruction. Tuberculosis osteomyelitis of the bone is a rare condition caused by the Mycobacterium tuberculosis. In the early stages, when plain radiographs are normal, MRI or CT may help to localise lesions. On plain radiographs, more advanced lesions may mimic chronic pyogenic osteomyelitis, Brodie�s abscess, tumours or granulomatous lesions. Biopsy is mandatory to confirm the diagnosis, and antituberculous drugs are the mainstay of treatment. When operative findings at biopsy have the features of skeletal tuberculosis curettage of the affected bone may promote earlier healing. Case Presentation: We report a 16 yr old female child who presented to our OPD in kurla babha hospital with chief complaints of pus discharge from the right leg, She had received antibiotics for the same but had no relief. There was no history of trauma in the past. On examination she had a sinus tract in the proximal aspect of tibia measuring 3x2x1cm. There was localised warmth and tenderness. Her blood investigations revealed raised ESR and CRP 30 & 44 respectively. Radiological investigation using x ray showed lytic lesion with sclerotic margins mimicking tuberculosis. She was then posted for debridement and curettage of the lesion and was started on AKT after her histopathology report revealed caseous lesion with giant cells & Gene expert positive for mycobacterium tuberculosis. Conclusion: In conclusion, thorough clinical examination, laboratory and radiological findings along with histopathological examination and polymerase chain reaction are essential for early diagnosis and accurate treatment of tuberculous osteomyelitis.