title: An exceptional location of tuberculous arthritis: The metatarsal phalangeal joint.
abstract: Osteoarticular tuberculosis is a rare type of tuberculosis. The spine is the most frequent location, while peripheral locations in the limbs are rare. We report a case of tuberculous osteoarthritis of the metatarsophalangeal joint of the first ray of the foot in a 48-year-old woman. The patient presented with painful swelling of the dorsum of the big toe, insidiously evolving for 6months. Diagnosis was obtained with histological study after surgical biopsy. Antitubercular chemotherapy for 12months promoted healing. Through this clinical case the authors describe the epidemiological, diagnostic features, and treatment of osteoarticular tuberculosis and discuss the causes of delayed diagnosis often encountered in these exceptional locations and differential diagnoses, gout in particular, for this particular case.
authors.affiliation: Department of Orthopedic Surgery and Trauma, MT Maamouri Hospital, Nabeul, Tunisia. Electronic address: mohamedali.sbai@rns.tn.
authors.forename: Mohamed Ali
authors.initials: MA
authors.lastname: Sbai
authors.affiliation: Department of Orthopedic Surgery and Trauma, MT Maamouri Hospital, Nabeul, Tunisia.
authors.forename: Sofien
authors.initials: S
authors.lastname: Benzarti
authors.affiliation: Department of Pharmacology, MT Maamouri Hospital, Nabeul, Tunisia.
authors.forename: Wafa
authors.initials: W
authors.lastname: Gharbi
authors.affiliation: Department of Orthopedic Surgery and Trauma, MT Maamouri Hospital, Nabeul, Tunisia.
authors.forename: Wadia
authors.initials: W
authors.lastname: Khoffi
authors.affiliation: Department of Plastic Surgery, La Rabta Hospital, Tunis, Tunisia.
authors.forename: Riadh
authors.initials: R
authors.lastname: Maalla
authors.affiliation: Department of Orthopedic Surgery and Trauma, MT Maamouri Hospital, Nabeul, Tunisia.
authors.forename: Adel
authors.initials: A
authors.lastname: Khorbi
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D001706:Biopsy; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D008683:Metatarsophalangeal Joint / Q000473:pathology*; D008853:Microscopy; D008875:Middle Aged; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*
chemical_list: D000995:Antitubercular Agents
keywords: Antituberculous chemotherapy; Foot; Metatarsophalangeal joint; Osteoarthritis; Tuberculosis