title: Tuberculous osteomyelitis in the ulna of a patient undergoing hemodialysis.
abstract: A 76-year-old woman on hemodialysis (HD) presented with pain and swelling in the left wrist and forearm. The osteomyelitis occurred in the part of the ulna adjacent to the arteriovenous fistula. Mycobacterium tuberculosis was identified in pus obtained from the left forearm, leading to a diagnosis of tuberculous osteomyelitis. The patient was treated with anti-tuberculous drugs and her symptoms improved. In this study, we report a case of tuberculous osteomyelitis occurring in the ulna, which is not the usual site of predilection for tuberculosis infection. As HD patients exhibit a high frequency of extrapulmonary tuberculosis, tuberculous osteomyelitis should be considered in the differential diagnosis of infectious osteomyelitis. In addition, it may be useful to perform stab cultures at an early stage in order to diagnose tuberculous osteomyelitis.
authors.affiliation: The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Nakazawa
authors.forename: Tomoya
authors.initials: T
authors.lastname: Nishino
authors.forename: Atsushi
authors.initials: A
authors.lastname: Mori
authors.forename: Tadashi
authors.initials: T
authors.lastname: Uramatsu
authors.forename: Yoko
authors.initials: Y
authors.lastname: Obata
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Arai
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Shoko
authors.initials: S
authors.lastname: Tsukasaki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Muraya
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Inoue
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000379:methods; D003475:Curettage / Q000379:methods; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010019:Osteomyelitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D011859:Radiography; D006435:Renal Dialysis / Q000379:methods*; D018570:Risk Assessment; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis* / Q000628:therapy; D014457:Ulna / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D000995:Antitubercular Agents