title: Isolated tuberculosis of sacrum with monoparesis: an atypical presentation.
abstract: Tuberculosis is a major health problem in developing nations. Spine is the most commonly affected site for skeletal tuberculosis but involvement of sacrum is rare. Isolated involvement of sacrum has been reported in literature but none of the reports has mentioned its clinical presentation as monoparesis. Our case presented with symptoms of sensory and motor deficit in right lower limb. The magnetic resonance imaging spine and non contrast computerized tomogram revealed a sacral lesion but were inconclusive of diagnosis. Histological examination after computed tomography guided biopsy revealed the condition as tuberculosis. Anti tubercular treatment was started after confirmation of diagnosis and continued for 18 months. Erythrocyte sedimentation rate and C-reactive protein drooped to normal range and patient was symptom free at two-year follow up. This case report intends to emphasize that sacral tuberculosis, being itself a rare condition, may present atypically as monoparesis.
authors.affiliation: Department of Orthopaedics, Post Graduate Institute of Medical Education Research, Chandigarh, India.
authors.forename: Radheshyam
authors.initials: R
authors.lastname: Sament
authors.affiliation: Department of Orthopaedics, Post Graduate Institute of Medical Education Research, Chandigarh, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Bachhal
authors.affiliation: Department of Orthopaedics, Post Graduate Institute of Medical Education Research, Chandigarh, India.
authors.forename: Nirmal Raj
authors.initials: NR
authors.lastname: Gopinathan
authors.affiliation: Department of Orthopaedics, Post Graduate Institute of Medical Education Research, Chandigarh, India.
authors.forename: Ramesh Kumar
authors.initials: RK
authors.lastname: Sen
keywords: Antibiotics; Monoparesis; Sacroiliac joint; Tuberculosis