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Abstract

Tuberculosis trochanteric bursitis accounts for around only %1 of all cases of musculoskeletal tuberculosis andmusculoskeletal tuberculosis is about %10 of extrapulmonary tuberculosis. Tuberculosis trochanteric bursitis associatedwith chronic nonspecific findings, such as local tenderness, swelling, pain. Differential diagnosis is difficult because ofnonspecific findings in plain radiographs and computed tomography. Inflammatory findings are determined in magneticresonance and scintigraphy. Definitive diagnosis is confirmed with biopsy, acid-fast staining and culture. Rice bodiescan see. Lymphocytes, histiocytes, plasma cells, langerhans cells with caseous necrosis in granulomatous inflammatorytissue are presented in histopathology. Surgical resection, debridement, irrigation and anti-tuberculosis drugs use intreatment. A 30 years old female patient was treated surgically due to trochanteric bursitis in another clinic last year.The patient was admitted to our clinic due to recurrence of the symptoms. Rice bodies had seen in surgery period in ourclinic. The patient received antituberculosis therapy for 10 months, after which complete remission was obtained

Keywords

• Tuberculosis bursitis; trochanteric; rice body

Tüberküloz Trokanterik Bursit: Bir Olgu Sunumu

Abstract

Akciğer dışı tüberkülozun %10’u kas iskelet sistemini tutarken, tüberküloz trokanterik bursit kas iskelet sistemi tüberkülozlarının sadece %1’ini oluşturmaktadır. Tüberküloz trokanterik bursit lokal hassasiyet, şişlik, ağrı gibi kronik nonspesifik bulgularla gelir. Düz grafi ve bilgisayarlı tomografi nonspesifik bulgular verdiğinden ayırıcı tanı güçtür. Manyetik rezonans ve sintigrafide enflamatuar bulgular saptanır. Biyopsi, mikobakterium kültürü ve aside dirençli boyama ile kesin tanı konur. Pirinç taneciği cisimcikleri görülebilir. Histopatolojide kazeifikasyon nekrozu olan granülomatöz enflamatuar doku ile birlikte lenfositler, histiyositler, plazma hücreleri, langerhans hücreleri görülür. Tedavi trokanterik bursanın cerrahi rezeksiyonu, debritman, irrigasyon ile birlikte antitüberküloz tedavidir. 30 yaşında trokanterik bursit nedeniyle daha önce başka bir klinikte cerrahi tedavi uygulanmış tekrarlayan trokanter bursiti olan bayan hastanın 4 yıl önce geçirilmiş pulmoner tüberküloz öyküsü mevcuttu. Hastanın cerrahi tedavisi sırasında trokanterik bursa içinde çok sayıda pirinç taneciği cisimciği görüldü. Hastaya 10 ay antitüberküloz tedavi uygulandı ve tedavi sonunda tam iyileşme sağlandı.

Keywords

• Tüberküloz bursit; trokanter; pirinç taneciği cisimciği

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