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<p>Tuberculosis (TB) remains a major global health challenge, predominantly affecting the pulmonary system. Extra-pulmonary TB (EPTB) is an uncommon manifestation, accounting for 1–3% of all TB cases, with musculoskeletal involvement being particularly rare. Isolated TB of the foot and ankle constitutes only 0.1–0.3% of EPTB cases and often mimics other conditions such as pyogenic infections, inflammatory arthritis, or neoplastic processes, leading to delayed diagnosis. A 9-year-old boy presented with progressive pain and swelling over the dorsum of his left foot for 1&#xa0;year. Physical examination revealed a diffuse, non-fluctuant mass over the midfoot with restricted range of motion. Laboratory findings showed an elevated erythrocyte sedimentation rate (ESR), while plain radiography and ultrasound were inconclusive. Magnetic resonance imaging (MRI) demonstrated osseous destruction predominantly involving the lateral cuneiform and cuboid bones, with lesser involvement of the intermediate cuneiform. A T1 isointense and T2/PDW hyperintense intertarsal lesion with avid post-contrast enhancement suggested granulation tissue and abscess formation. Fine needle aspiration cytology (FNAC) confirmed the diagnosis of tuberculous osteomyelitis with arthritis. The patient was started on anti-TB therapy, resulting in significant symptom improvement by the second month of treatment. Midfoot tuberculosis can mimic other conditions, causing diagnostic delays. MRI enables early, accurate detection in pre-destructive phases, facilitating timely, targeted treatment and improved outcomes in isolated tuberculous osteomyelitis.</p>

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Isolated Midfoot Tuberculosis in a 9-Year-Old Child: A Case Report

  • 期刊论文

  • 发表日期：

    2025年6月6日

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  • Suleiman A. Belay,
  • Michael A. Negussie,
  • Helina K. Teklehaimanot,
  • Abel T. Abebe,
  • Mikiyas G. Teferi,
  • Alemayehu T. Toni

摘要

Tuberculosis (TB) remains a major global health challenge, predominantly affecting the pulmonary system. Extra-pulmonary TB (EPTB) is an uncommon manifestation, accounting for 1–3% of all TB cases, with musculoskeletal involvement being particularly rare. Isolated TB of the foot and ankle constitutes only 0.1–0.3% of EPTB cases and often mimics other conditions such as pyogenic infections, inflammatory arthritis, or neoplastic processes, leading to delayed diagnosis. A 9-year-old boy presented with progressive pain and swelling over the dorsum of his left foot for 1 year. Physical examination revealed a diffuse, non-fluctuant mass over the midfoot with restricted range of motion. Laboratory findings showed an elevated erythrocyte sedimentation rate (ESR), while plain radiography and ultrasound were inconclusive. Magnetic resonance imaging (MRI) demonstrated osseous destruction predominantly involving the lateral cuneiform and cuboid bones, with lesser involvement of the intermediate cuneiform. A T1 isointense and T2/PDW hyperintense intertarsal lesion with avid post-contrast enhancement suggested granulation tissue and abscess formation. Fine needle aspiration cytology (FNAC) confirmed the diagnosis of tuberculous osteomyelitis with arthritis. The patient was started on anti-TB therapy, resulting in significant symptom improvement by the second month of treatment. Midfoot tuberculosis can mimic other conditions, causing diagnostic delays. MRI enables early, accurate detection in pre-destructive phases, facilitating timely, targeted treatment and improved outcomes in isolated tuberculous osteomyelitis.