title: Bilateral patellar tuberculosis masquerading as infected infrapatellar bursitis.
abstract: A 30-year-old woman presented to our outpatient department with complaints of pain and swelling in bilateral infrapatellar regions and a discharging sinus in the right knee over the duration of one year. Radiographs showed lytic regions in bilateral patellae. Samples sent from material curetted from sinus yielded no organism but histopathology reported granulomatous inflammation. Following a fresh magnetic resonance imaging (MRI) scan that revealed the infrapatellar pad of fat communicating with the patellar lesions, an exploration and evacuation was done. Material sent revealed epithelioid cell granulomas with caseous necrosis consistent with tuberculosis (TB). The patient was put on first line anti-tubercular treatment (ATT) and has responded favourably with healing of sinus and patellar lesions. Bilateral infrapatellar bursitis is not rare. However patellar TB as a cause for OMIT is not a common diagnosis. A bilateral patellar involvement has not been reported in literature to the best of our knowledge.
authors.affiliation: 1 Clinical Fellow and Associate, Department of Orthopaedics, Delhi Institute of Trauma and Orthopaedics, Sant Parmanand Hospital, Civil Lines, New Delhi, India.
authors.forename: Ravi
authors.initials: R
authors.lastname: Sreenivasan
authors.affiliation: 2 Professor, Department of Orthopaedics, University College of Medical Sciences & GTB Hospital, University of Delhi, New Delhi, India.
authors.forename: Rehan Ul
authors.initials: RU
authors.lastname: Haq
mesh_terms: D000328:Adult; D002062:Bursitis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D011859:Radiography; D014376:Tuberculosis / Q000175:diagnosis*
keywords: Tuberculosis (TB); infrapatellar bursitis; osteoarticular