Tibial osteitis caused by Mycobacterium tuberculosis

TL;DR

A 52-year-old woman was diagnosed with tibial osteitis caused by tuberculosis after presenting with a painful leg swelling.

Contribution

The paper highlights the importance of considering tuberculosis as a cause of atypical bone lesions in endemic regions.

Findings

Tibial osteitis was confirmed as caused by Mycobacterium tuberculosis through imaging and lab tests.

Pulmonary consolidation and splenic nodules were also found in the patient.

Early suspicion of tuberculosis is crucial for timely diagnosis and treatment in endemic areas.

Abstract

Tuberculosis is a major scourge, posing a serious public health problem in countries where it is endemic. Osteoarticular involvement accounts for 3–5% of all tuberculosis cases and 10–15% of extrapulmonary tuberculosis cases. We report a case of tibial osteitis caused by Mycobacterium tuberculosis in a 52-year-old female patient who presented to the trauma department at the Mohammed V Military Teaching Hospital with a painful swelling of the lower part of her left leg. Standard X-rays and computed tomography scans revealed bone involvement, specifically in the tibia. Additional investigations revealed pulmonary consolidation and splenic nodules. Microscopy (Ziehl–Neelsen staining), GeneXpert MTB/RIF and histopathological examination all returned positive results for M. tuberculosis. In an endemic context, any persistent and atypical bone lesion should raise suspicion of osteoarticular tuberculosis to enable rapid diagnosis and appropriate therapeutic management. In the absence of malignant tumours and other differential diagnoses, the diagnosis of skeletal tuberculosis must be considered, even in the absence of specific clinical signs.

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