Tuberculous Arthritis: A Forgotten Diagnosis During Pandemic Covid-19

Abstract

Tuberculosis (TB) is a respiratory disease that primarily affects the lungs. The challenge is to recognize the characteristic of TB disease, including extrapulmonary presentation. TB arthritis is an extrapulmonary TB presentation in the joint, which is frequently neglected and misdiagnosed. A 41-year-old female patient was presented with a major complaint of chronic pain in her left wrist for three months. The patient had a low-grade fever without respiratory symptoms. Local examination revealed swelling, warmth and tenderness. Erythrocyte sedimentation rate (ESR) was increased and chest radiograph demonstrated pulmonary TB. She underwent arthrotomy debridement and culture examination. We initiated adjuvant anti-tuberculous treatment. On the evaluation, she reported relief from pain and showed improvement in general condition. TB arthritis is unique due to its rare incidence and unspecific clinical manifestations. A better understanding of these issues will prevent possible diagnostic errors. Prompt treatment was crucial to maintain joint function and prevent permanent destruction.

Keywords

• Wrist joint
• Tuberculous arthritis
• Extrapulmonary tuberculosis
• Anti-tuberculous chemotherapy