title: Unusual presentations of osteoarticular tuberculosis in two paediatric patients.
abstract: Tuberculosis is a universal mimicker and thus could be a differential diagnosis of any osteolytic lesion. Bone biopsy is crucial in these cases for culture and histological proof of tuberculous infection. This is a case report of two paediatric patients with unusual presentations of tuberculosis. One patient presented with knee pain and had imaged findings of an osteolytic lesion at the epiphysis. Interval scan showed spread of the lesion through the physis to the metaphyseal region. The second patient presented with hip pain and an osteolytic lesion of the acetabulum. He was subsequently found to have involvement of the brain and spine as well. Both patients were diagnosed with tuberculosis by bone biopsy for culture and pathological examination. They were treated successfully with antituberculous medications without chronic sequelae. These two patients showed that early recognition and prompt treatment are critical for management of tuberculosis to avoid chronic sequelae.
authors.affiliation: Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, Hong Kong. jcheung98@hotmail.com
authors.forename: Jason Pui Yin
authors.initials: JP
authors.lastname: Cheung
authors.forename: Kenneth Wai Yip
authors.initials: KW
authors.lastname: Ho
authors.forename: Ying Lee
authors.initials: YL
authors.lastname: Lam
authors.forename: Tony Wai Hung
authors.initials: TW
authors.lastname: Shek
mesh_terms: D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001842:Bone and Bones / Q000382:microbiology* / Q000473:pathology; D001921:Brain; D002675:Child, Preschool; D005260:Female; D006615:Hip; D006801:Humans; D007717:Knee; D008297:Male; D059352:Musculoskeletal Pain / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D009169:Mycobacterium tuberculosis; D013131:Spine; D014394:Tuberculosis, Osteoarticular / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents