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CASE REPORT
Tuberculosis of lunate as an isolated intraosseous osteolytic lesion in an adult: a diagnostic challenge
  1. Prasoon Kumar,
  2. Sameer Aggarwal,
  3. Rajesh Kumar Rajnish and
  4. Saurabh Agarwal
  1. Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Prasoon Kumar, drprasoonksingh{at}gmail.com

Abstract

In an endemic zone of tuberculosis (TB), osseous involvement is a relatively common presentation. Spine and long bones are the the most common nidus of TB. Smaller bones and joints are relatively less involved. Thorough clinical examination and history of typical constitutional symptoms like weight loss, fever and loss of appetite are the diagnostic aids for initiating early treatment. Wrist and hand involvement is a rare occurrence and often presents atypically without any obvious symptoms or signs. This results in delayed diagnosis and worse outcome. TB of lunate without articular involvement is a very rare subset and we present such an isolated case of TB involving the lunate, without any typical symptoms, with the patient complaining of vague pain without any restriction of joint mobility. TB was diagnosed with the aid of radiology, haematology and histopathology. 18 months of multidrug antitubercular treatment was given, to which the patient responded well.

  • infections
  • musculoskeletal and joint disorders
  • bone and joint infections
  • TB and other respiratory infections
  • orthopaedics
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Footnotes

  • Contributors PK: patient data, literature and writing. SA: literature and editing. RKR: patient follow-up and writing. SA: images and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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