title: Lytic lesions of distal radius in children: a rare tubercular presentation.
abstract: BACKGROUND
  We report the presentation, management, and outcome in five children with osteoarticular tuberculosis of distal radius.
  
  
  METHODS
  PATIENTS were recruited in a prospective study. All patients underwent an open biopsy, curettage and diagnosis confirmed by histopathological/microbiological examination. In cavitary lytic lesions, bone grafting was also undertaken. The multidrug anti-tubercular chemotherapy was given for one year.
  
  
  METHODS
  Five patients were included in the study. The average follow-up post-completion chemotherapy was 34.8 months. Bony lesions presented as a poorly defined radiolucent lytic area in metaphysis, cavitary lytic lesions with or without sequestrum or spanned the physeal plate. At final follow-up, except for one case, a full pain free range of movements was achieved in all cases. Fibular graft was used in two cases with cavitary lesions and incorporated well in both cases.
  
  
  CONCLUSIONS
  Tuberculosis can involve the adjacent physis and can be multifocal. The presentation is usually lytic with minimal sclerosis. For smaller ill defined lesions, curettage and multidrug anti-tubercular chemotherapy results in excellent outcome. Cavitary lytic lesions should be bone grafted as there is a risk of pathological fractures.
authors.affiliation: Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalya, Geeta Colony, Delhi-31, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Agarwal
authors.forename: Kumar Shashi
authors.initials: KS
authors.lastname: Kant
authors.forename: Anubrat
authors.initials: A
authors.lastname: Kumar
authors.forename: Abbas
authors.initials: A
authors.lastname: Shaharyar
authors.forename: Indreshwar
authors.initials: I
authors.lastname: Verma
authors.forename: Tarun
authors.initials: T
authors.lastname: Suri
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D016025:Bone Transplantation; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003475:Curettage; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D011884:Radius; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy
chemical_list: D000995:Antitubercular Agents
keywords: Children; Distal Radius; Osteomyelitis; Tuberculosis; Wrist