Journal of Foot and Ankle Surgery (Asia Pacific)

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VOLUME 9 , ISSUE 4 ( October-December, 2022 ) > List of Articles


Multifocal Tubercular Osteomyelitis of Metatarsal and Ulna: A Case Report

Neetin P Mahajan, Pranay Kondewar, GS Prasanna Kumar, Shubham Atal, Amey Sadar

Keywords : Antitubercular treatment, Curettage, Metatarsal and ulna, Tubercular osteomyelitis

Citation Information : Mahajan NP, Kondewar P, Kumar GP, Atal S, Sadar A. Multifocal Tubercular Osteomyelitis of Metatarsal and Ulna: A Case Report. J Foot Ankle Surg Asia-Pacific 2022; 9 (4):183-187.

DOI: 10.5005/jp-journals-10040-1193

License: CC BY-NC 4.0

Published Online: 07-10-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Introduction: Skeletal tuberculosis is relatively uncommon compared with the pulmonary form of tuberculosis. Bones and joints are affected in 1–3% of all cases, the spine and hip are most commonly involved. Localization in the foot is very rare. Management of tubercular osteomyelitis of metatarsals includes medical/surgical or both depends on the severity and location of the disease. Case description: A 25-year-old female patient presented with complaints of pain, swelling over the medial aspect of the right foot for 6 months. She had a history of left proximal ulna tubercular osteomyelitis 6 years ago, for which curettage was done and she took AKT for 6 months. X-ray foot showed a cavitary lytic lesion in the proximal part of the first metatarsal bone. It was managed with debridement, curettage, and saucerization of the metatarsal bone and CAT2 AKT. At present 1-year follow-up, the patient is comfortable with no pain, difficulty in weight-bearing, and no recurrence. X-ray foot revealed complete filling of the defect in the metatarsal with remineralization with no recurrence and fracture. Conclusion: Although metatarsal and olecranon tubercular osteomyelitis involvement is rare, early diagnosis and management help in getting a better outcome. Early surgical intervention and antitubercular treatment help in preventing further progression to adjacent joint/bone/soft tissue. Along with long-term AKT, high protein and nutritious diet help in maintaining good immunity and helps in preventing recurrence.

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