title: Tuberculous bursitis of the greater trochanter mimicking ankylosing spondylitis.
abstract: Tuberculous trochanteric bursitis (TTB) is a rare condition that accounts for 1% of musculoskeletal tuberculosis cases. Extrapulmonary TB is usually diagnosed late because of reduced diagnostic suspicion, particularly in the absence of signs of systemic infection. Herein, we report a case of right hip pain that was misdiagnosed as ankylosing spondylitis. The patient had a history of inflammatory back pain with morning stiffness. However, HLA-B27 was negative. Sacroiliac magnetic resonance imaging (MRI) revealed a giant multiloculated collection (27×16×10 cm). Percutaneous drainage was performed andMycobacterium tuberculosiswas observed in fluid culture. The patient was treated by drainage along with antituberculosis therapy. After 1 year of antituberculosis therapy, control MRI revealed total resolution of the large fluid collection. It is important to emphasize that fever or general symptoms are absent in patients with TTB, as observed in the present case. In endemic countries, TTB should be kept in mind in the differential diagnosis of a patient presenting with chronic hip pain without fever, weight loss, and constitutional symptoms.
authors.affiliation: Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Öykü
authors.initials: Ö
authors.lastname: Tayfur
authors.affiliation: Department of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Kılıç
authors.affiliation: Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Karadağ
authors.affiliation: Department of Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Akdoğan
authors.affiliation: Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ülkü
authors.initials: Ü
authors.lastname: Kerimoğlu
authors.affiliation: Department of Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ömrüm
authors.initials: Ö
authors.lastname: Uzun
keywords: Tuberculosis; ankylosing spondylitis; trochanteric bursitis