DR. SAKTHI BHALAN PANDIARAJAN, DR. ANBUMARAN PARIVAKKAN MANI, DR. PRASANTH GURURAJ, DR. SOWMITHA SG, DR. GANGADHARAN VADIVELU
DOI: https://doi.org/Tuberculosis (TB) continues to pose a global health burden, with extrapulmonary forms accounting for a significant minority of cases. Skeletal involvement is relatively uncommon, representing only 2-4% of extrapulmonary TB, and disease of the ankle joint is particularly rare, occurring in about 1-4% of skeletal cases. We present the case of a 63 year old man with progressive pain and swelling of the right ankle for six months, with a remote history of similar joint involvement. Clinical assessment showed joint tenderness and restricted mobility. Chest radiography revealed pulmonary lesions, and sputum CBNAAT confirmed Mycobacterium tuberculosis sensitive to rifampicin. Fine-needle aspiration cytology of the ankle joint demonstrated granulomatous inflammation with histiocytes and Langerhans giant cells, supporting the diagnosis of tubercular arthritis. The patient was treated with standard antitubercular therapy and showed complete recovery. This case emphasizes the need to consider tuberculosis in patients with chronic monoarthritis, particularly in TB-endemic regions, and highlights the role of combined clinical, radiological, and pathological assessment in achieving timely diagnosis and preventing disability.
