Tuberculosis in Foot and Ankle

Choi, Jang Seok; Gwak, Heui Chul; Kim, Jung Han; Chung, Hoon Jae

Abstract

PURPOSE
To emphasize the importance of considering tuberculosis in atypical cases of foot and ankle by reporting clinical results of those cases.
MATERIALS AND METHODS
Seven cases which were diagnosed as tuberculosis around foot and ankle from March 1996 to June 2007 were included. We reviewed initial impressions, the time to be diagnosed, clinical symptoms, laboratory findings, radiological findings and the clinical results and complications.
RESULTS
We followed up at least 6 months (6~24 months) after surgery in all cases. Initially 2 cases had been diagnosed as cellulitis, 4 cases as chronic osteomyelitis, and 1 case as an ankle instability. Tuberculosis was diagnosed after biopsy in all cases. Mean duration of symptom was 15 months (6~36 months) except in infants. There were various radiologic manifestations such as osteopenia, bony erosion or destruction and cystic changes. Symptoms were relieved in all cases within 4 months with chemotherapy followed by surgical biopsy, except one ankle which had been misdiagnosed as ankle instability and joint destruction was developed after modified Brostrom surgery.
CONCLUSION
It is important to perform a surgical biopsy for diagnosis and proper management even with a faint suspicion on tuberculosis in foot and ankle. And in case of need, when surgical biopsy is performed, curettage procedure may help to improve clinical result.