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Rare disease
CASE REPORT
Carpal synovitis with capitate bone tuberculosis in a child
  1. André Grenho1,
  2. Joana Arcângelo1,
  3. Pedro Jordão2,
  4. Catarina Gouveia3
  1. 1Orthopaedics Department - Hospital de Curry Cabral, Centro Hospitalar de Lisboa Central EPE, Lisbon, Portugal
  2. 2Orthopaedics Department - Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central EPE, Lisbon, Portugal
  3. 3Pediatrics Department - Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central EPE, Lisbon, Portugal
  1. Correspondence to André Grenho, andregrenho{at}gmail.com

Summary

We present a 10-year-old boy with 2-month duration non-traumatic wrist pain and inflammatory signs. Due to elevated inflammatory markers on blood tests, with an increase in radiocarpal and intercarpal joints synovial fluid and no bony lesions, the patient was submitted to wrist arthrocentesis for the suspicion of septic arthritis. The patient did not improve on conventional treatment, however. An MRI showed synovitis around the carpus and a lytic lesion of the capitate bone due to osteomyelitis. A biopsy was able to identify the causative agent as Mycobacterium tuberculosis, and the patient was treated with antibiotics. He improved significantly, with no pain and signs of normal capitate bone remodelling on the last radiograph.

  • bone and joint infections
  • TB and other respiratory infections
  • orthopaedics
  • paediatrics

https://doi.org/10.1136/bcr-2017-223459

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    Footnotes

    • Contributors AG and JA treated the patient and wrote the manuscript. CG was the senior infectious disease consultant on the case and reviewed the manuscript. PJ was the senior orthopaedic surgery consultant on the case and reviewed the manuscript.

    • 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.

    • Patient consent Obtained.

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