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J Family Med Prim Care. 2014 Apr;3(2):129-31. doi: 10.4103/2249-4863.137629.

Ankle and foot tuberculosis: a diagnostic dilemma.

Author information

  • 1Department of General Surgery, S.C.B. Medical College, Cuttack, Orissa, India.
  • 2Department of Physiology, S.C.B. Medical College, Cuttack, Orissa, India.
  • 3Department of Pulmonary Medicine, S.C.B. Medical College, Cuttack, Orissa, India.

Abstract

AIM AND OBJECTIVE:

To know the biological behavior of ankle and foot tuberculosis (AFTB) and to know the reasons for delay in diagnosis and treatment of AFTB in our population.

MATERIALS AND METHODS:

Patients with non-healing ulcers/sinuses/swellings in the ankle and foot region are the subjects of present study. Detailed clinical history, physical examination and relevant investigations were done in all cases. Pus/wound discharge for acid fast bacillus (AFB) study and biopsy from wound margin/sinus tract was taken in all the cases.

RESULTS:

During the period from July 2007-June 2012, 20 cases of AFTB were treated. Out of them five cases were difficult to diagnose and a mean period of 6 month to 5year was elapsed before final diagnosis was established. Out of these five cases - three cases were diabetic with ulcers and sinuses in the heel and ankle region. One case was wrongly diagnosed as angiodysplasia with A-V malformation of foot and diagnosis was delayed for 5 year. In one case of rheumatoid arthritis with abscess in ankle joint, the diagnosis was delayed for 1year.

CONCLUSION:

AFTB is very rare condition. AFTB is suspected in cases with long standing pain/swelling/discharging sinus in the foot and thorough investigations is must to differentiate from other foot diseases. Diagnosis is delayed due to lack of clinical suspicion and non-confirmatory biopsy reports. Early diagnosis and ATT for 9-18 months is must in all cases of AFTB to prevent joint involvement and other complications.

KEYWORDS:

Ankle; foot; tuberculosis

PMID:
25161969
[PubMed]
PMCID:
PMC4139992
Free PMC Article
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