The Great Imitator - Disseminated Tuberculosis Presenting as Baker’s Cyst: A Case Report
https://doi.org/10.5704/MOJ.2203.020
- Author:
Shakya A
1
;
Patil N
1
;
Kakadiya G
1
;
Soni Y
1
Author Information
1. Department of Orthopaedics, Topiwala National Medical College, Mumbai, India
- Publication Type:Journal Article
- Keywords:
tuberculous arthritis, pigmented villonodular synovitis, knee, delayed diagnosis, multifocal
- From:
Malaysian Orthopaedic Journal
2022;16(No.1):126-129
- CountryMalaysia
- Language:English
-
Abstract:
Tuberculosis is known to be a great mimicker, and it can
present in a myriad of ways, which often result in an
incorrect diagnosis. In a country that is endemic to
tuberculosis, the presentation can take many forms ranging
from tumour to trauma. We present a case of Baker’s cyst
that was provisionally diagnosed as pigmented villonodular
synovitis (PVNS) of the knee and eventually turned out to be
tuberculous arthritis. A 46-year-old male presented with an
insidious swelling on the posterior aspect of his knee for one
year. Magnetic resonance imaging was suggestive of PVNS
as the likely diagnosis. The patient presented 21 days later
with a foot drop. On following-up with further
investigations, he was found to have a lesion at the level of
the L4-L5 spine. Chest radiograph changes were suggestive
of tuberculosis. A synovial biopsy of the knee was done, and
the tuberculosis culture report was positive. The patient was
started on anti-tubercular treatment and then operated on,
with arthroscopic synovectomy and posterior open cyst
excision. The histology report was positive for tuberculous
synovitis. The patient completed the course of antitubercular drugs and had physiotherapy. He demonstrated a
clinically and radiologically healed disease at the final
follow-up with a good functional outcome. Clinicians must
have a high index of suspicion for tuberculosis, especially in
endemic areas. Getting a chest radiograph is recommended
in every case. Early diagnosis with the appropriate treatment
will give a good functional outcome for the patient.
- Full text:16.2022my1237.pdf
