Tuberculous Arthritis of the Ankle Joint Mimicking Pigmented Villonodular Synovitis

Abstract

Osteoarticular tuberculosis (TB) of the ankle joint is rare, and there is a delay in diagnosis in most cases. All patients with the disease complained of swelling and pain in the affected ankle. Ankle TB is a disorder that can be simply misdiagnosed. The delay in diagnosis may range from months up to years. All patients in this series had already been diagnosed with ankle TB by the time they visited our hospital. The current case was reported in a middle-aged male nurse with ankle pain, ulcer, and limited range of movement. The classical clinical manifestations of TB were absent on free chest radiography. Ulcer biopsy showed TB infection with no lymph nodes. Nonspecific inflammation was initially treated, but, subsequently, anti-TB treatment was useful.

Keywords: ankle; case report; diagnosis; extrapulmonary tuberculosis; tuberculosis.

Figure 1. Lateral side image of the left ankle showing ulcer

Figure 2. (A) Anteroposterior and (B) lateral plain radiographs showing mild arthritic changes and soft tissue swelling

Figure 3. (A) T1- and (B) T2-weighted coronal view MRI of the left ankle showing multinodular mass and low signal intensities indicating that hemosiderin deposits were diagnostic of diffuse pigmented villonodular synovitis