The authors in this case report highlight the poor outcome of radiation synovectomy (RSV) for repeated knee joint effusion in a patient with histopathologically proven nonspecific arthritis. There was partial response initially following RSV but later follow-up showed recurrence in joint effusion with limited and painful mobility of the knee joint. Subsequent surgical synovectomy and histopatho...

Seven months after undergoing kidney transplantation, a 56-year-old woman presented with papules and ulcers in her right forearm. The patient received antibiotics for 8 months with limited improvement. Eleven months after symptom onset, she presented with acute arthritis in her left knee. Asynovial fluid culture yielded Mycobacterium tuberculosis, and a forearm ulcer biopsy showed granulomatous...

We describe a case of septic arthritis of the knee in which the diagnosis of tuberculosis was masked by an initial culture growth of Staphylococcus aureus. This led to a delay in diagnosis and an adverse outcome. In the appropriate clinical setting, we suggest that the index of suspicion for skeletal tuberculosis be raised in developed countries in order to avoid diagnostic delay, by requesting...

Clinical series of primary epiphyseal and metaepiphyseal tubercular osteomyelitis are few. The purpose of our study was to retrospectively review the presentation, healing response and functional results of 8 such cases in children. MATERIAL AND METHODS The patients were evaluated for pain, deformity, range of motion, limb length discrepancy (if any) and recurrence. Serial radiographs of the ...

Diagnosis of extrapulmonary tuberculosis (TB) is often challenging. In this work we discuss the utility of an assay for Lipoarabinomannan (LAM) antibody detection in synovial fluid. LAM is one of the three major groups of lipopolysaccharides within the Mycobacterium tuberculosis (MTB) cell wall. An ELISA based test was used to investigate the presence of antibodies against LAM in an immunocompe...

This article reports a rare case of late-onset tubercular infection following total knee arthroplasty in a 60-year-old woman who had been treated with a full course of antitubercular therapy for latent tuberculosis almost 25 years ago. Because no clear guidelines exist for optimal management of disease reactivation in the prosthetic knee joint, the authors performed a literature review and atte...

The indolent and nonspecific presentations of tuberculous arthritis and pyomyositis render their diagnosis a great challenge for clinicians. We describe a 78-year-old man with swelling and pain of right knee for 6 months. The patient was empirically treated for tuberculosis because positive enzyme-linked immunospot assay for interferon-γ of blood was reported at 2 days after aspiration of synov...

A 20-month-old afebrile boy living in northern Taiwan presented with swelling of the right knee for 5 days. No other respiratory or gastrointestinal symptoms were associated. A bacille Calmette–Guérin (BCG) vaccination had been performed when he was 1 month of age. The X-ray showed no bony destruction, and the sonography revealed some fluid accumulation in the right suprapatellar pouch. Arthroc...

A female infant (age, 2 years and 4 months) from the city of São Paulo, Brazil, had been vaccinated with BCG in the maternity ward and presented with a 15-day history of pain in the right leg and impaired ambulation. The patient was treated with a nonsteroidal anti-inflammatory drug and showed improvement. However, two weeks after the drug had been discontinued, she showed worsening. An X-ray o...