Poncets Disease: TB Reactive Arthritis: A Case Report

Poncets disease is a rare reactive polyarthritis, which can precede, follow or manifest concomitantly with active tuberculosis, mostly extrapulmonary. Diagnosis is made only on clinical grounds and mainly on complete resolution of the arthritis with ATT. Here we report a case of Poncets disease accompanied with ileocaecal tuberculosis. A 37 year old male presented with H/O 2 months of fever, 1 month of diarrhoea and loss of weight about 5 kg in the last 2 months, with no previous h/o TB or contact with TB. On examination patient was emaciated with mild swelling in right iliac fossa and other systems were clinically normal. Provisional diagnosis of ileocaecal tuberculosis was made and while investigating for the same, patient developed asymmetric polyarthritis of large joints, CT abdomen showed mesenteric lymphnodes enlargement of greater than2 cm size and thickening of ileum and ileocaecal junction. TB QUANTIFERON GOLD test was also positive. ATT was started and on review after 3 weeks, all signs and symptoms of arthritis completely resolved.