title: Isolated tuberculous osteomyelitis of the talonavicular joint without pulmonary involvement-a rare case report.
abstract: Tuberculosis is one of the leading causes of death worldwide amongst curable diseases. It is estimated that one-third of the world's population has been diagnosed with tuberculosis infection [1]. The prevalence is on the rise with an estimated 9.4 million new cases per year worldwide [1]. Tuberculosis most commonly presents with pulmonary involvement. However, approximately 23-30% of patients found to be infected with tuberculosis have extrapulmonary symptoms [2]. Of those, only 1-3% have been found to have osseous disease. Skeletal involvement with a primary focus of tuberculosis usually affects major weight-bearing joints such as the hip and knee. Tuberculosis infections of the foot and ankle are very rare, accounting for 1% of all tuberculosis infections [2-4]. Difficulties arise in the timing of diagnosis, patient compliance of therapy and awareness of the less obvious presenting symptoms. Musculoskeletal tuberculosis, although rare, can be a problem. Its uncommon site, non-specific presenting symptoms and its ability to mimic numerous disorders make it more difficult to formulate a definitive diagnosis and, in turn, leads to therapeutic delays [5-7]. It is for this reason that we report this case in an effort to promote awareness.
authors.affiliation: Orthopaedic Department, Queen Elizabeth Hospital, Kings Lynn PE30 4ET, UK.
authors.forename: Wystan
authors.initials: W
authors.lastname: Chevannes
authors.affiliation: Orthopaedic Department, Queen Elizabeth Hospital, Kings Lynn PE30 4ET, UK. Electronic address: a.memarzadeh@doctors.org.uk.
authors.forename: Arman
authors.initials: A
authors.lastname: Memarzadeh
authors.affiliation: Orthopaedic Department, Queen Elizabeth Hospital, Kings Lynn PE30 4ET, UK.
authors.forename: Chandra
authors.initials: C
authors.lastname: Pasapula
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D010019:Osteomyelitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D013640:Tarsal Joints; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents
keywords: Arthritis; Midfoot; Osteomyelitis; TB; Talonavicular; Tuberculosis