Bir Çocuk Olguda Ayak Bileğinde Artritin Nadir Görülen Bir Nedeni: Tüberküloz

Yıl 2014, Cilt: 8 Sayı: 3, 155 - 158, 01.06.2014

Gülsüm İcal Bayhan Gönül Tanır

Öz

Tüberkülozun osteoartiküler tutulumu sıklıkla spinal kanal tutulumu ile seyreder. Ekstraspinal periferal eklem tutulumu nadir görülmektedir. Genellikle kalça ve diz tutulur ve tutulum genellikle monoartikülerdir. Osteoartiküler tutulumun tanısı zordur, çünkü pek çok kemik eklem patolojisini taklit edebilir. Bu nedenle sıklıkla hastalar yanlış tanı almakta ve hastalık ileri evrelerde tanı alarak tedavi edilmektedir. Bu yazıda ayak bileğinde dört aydır devam eden artrit yakınmaları ile başvurup, tüberküloz artrit ve osteomiyeliti tanısı alan, altı buçuk yaşında bir erkek olguyu, tüberkülozun monoartritin oldukça nadir bir etkeni olması sebebiyle sunuldu. Çocuklarda monoartritin ayırıcı tanısında tüberkülozun akılda tutulmasının önemine dikkat çekmek istendi.

Anahtar Kelimeler

Artrit, Ayak bileği, Mycobacterium tuberculosis, Talus

A Rare Cause of Ankle Arthritis in a Child: Tuberculosis

Öz

Osteoarticular tuberculosis is often characterized by involvement of the spinal canal. Extraspinal peripheral joint involvement is rare. The most commonly affected peripheral joints are the hips and the knee and the involvement is usually monoarticular. Diagnosis of osteoarticular tuberculosis is diffi cult because it can mimic many other bone joint pathologies. Patients are therefore often misdiagnosed with another disease and tuberculosis is diagnosed in an advanced stage. In this article we present a 6.5-year-old male with ankle arthritis symptoms for 4 months. The patient was diagnosed with tuberculous arthritis and osteomyelitis. Tuberculosis is an uncommon cause of monoarthritis. We wanted to emphasize that the differential diagnosis of monoarthritis in children should include tuberculosis

Anahtar Kelimeler

Arthritis, Ankle, Mycobacterium tuberculosis, Talus

Kaynakça

• Nelson LJ, Wells CD. Global epidemiology of childhood tuberculo- sis. Int J Tuberc Lung Dis 2004;8:636-47.
• http://apps.who.int/iris/bitstream/10665/ 75938/1/ 9789241564502_eng.pdf (erişim tarihi 10 Haziran 2013)
• Ruderman EM, Flaherty JP. Mycobacterial Infections of bones and joints. In: Firestrein GS, Budd RC, Gabriel SE, Mclnnes IB, O’Dell JR, (eds). Kelley’s Textbook of Reumatology. 9th ed. Philedelphia: Elsevier, 2013:1829-40.
• Pääkkönen M, Peltola H. Bone and Joint Infections. Pediatr Clin N Am 2013;60:425-36.
• Pigrau-Serrallach C, Rodríguez-Pardo D. Bone and joint tuberculosis. Eur Spine J 2013;22: 556-66.
• Wardle N, Ashwood N, Pearse M. Orthopaedic manifestations of tuberculosis. Hosp Med 2004;65:228-33.
• Ocguder A, Tosun O, Akkurt O, Oguz T, Colakoglu T. Tuberculosis of the foot: A rare involvement in osteoarticular tuberculosis. J Clin Rheumatol 2006;12:304-5.
• Malaviya AN, Kotwal PP. Arthritis associated with tuberculosis. Best Pract Res Clin Rheumatol 2003;17:319-43.
• Agarwal A, Qureshi NA, Khan SA, Kumar P, Samaiya S. Tuberculosis of the foot and ankle in children. J Orthop Surg (Hong Kong) 2011;19:213-217. PMID: 21857048
• Mittal R, Gupta V, Rastogi S. Tuberculosis of the foot. J Bone Joint Surg Br 1999;81: 997-1000.
• devam ediyordu. TCT başlangıçta negatifken, daha sonra po
• Rafi qi K, Yousri B, Arihi M, Bjitro C, Aboumaarouf M, El Andaloussi M. Unusual locations of osteoarticular tuberculosis in children: A report of 12 cases. Orthop Traumatol Surg Res 2013;99:347-51.
• Ferguson KB, Jones CE, Thomson AG, Moir JS. A rare case of tuberculosis of the midfoot. Foot Ankle Spec 2012;5:327-9.
• De Vuyst D, Vanhoenacker F, Gielen J, Bernaerts A, De Schepper AM. Imaging features of musculoskeletal tuberculosis. Eur Radiol 2003;13:1809-19.
• Bockenstendtlk LK. Lyme disease. In: Firestrein GS, Budd RC, Gabriel SE, Mclnnes IB, O’Dell JR (eds). Kelley’s Textbook of Rheumatology. 9th ed. Philedelphia: Elsevier, 2013:1815-28.