Poncet's Disease Initially Managed as Osteoarthritis: Case Report From a Peripheral Centre in Kenya

TL;DR

A case of Poncet's disease, a rare form of tuberculosis, was misdiagnosed as osteoarthritis in Kenya.

Contribution

Highlights the diagnostic challenge of Poncet's disease in TB-endemic regions and the need for high suspicion.

Findings

Poncet's disease was initially misdiagnosed as osteoarthritis due to lack of constitutional symptoms.

Diagnosis was confirmed after the patient developed TB symptoms like weight loss and fever.

The case underscores the importance of considering TB in patients with unexplained polyarthritis.

Abstract

Tuberculosis (TB) remains a major public health challenge in Kenya. Though a multisystemic disease, some of the manifestations of tuberculosis such as Poncet's disease are rare and should be considered in patients presenting with symmetric polyarthritis in TB‐endemic areas. We present a case of a 49‐year‐old male patient who presented with sub‐acute ankle and foot swelling and was initially managed for osteoarthritis without improvement. At initial presentation, the history of constitutional features was equivocal, missing a potential opportunity to diagnose a systemic illness. On developing constitutional features of weight loss and fevers, a suspicion of tuberculosis was made, and a diagnosis of pulmonary tuberculosis confirmed on chest imaging and sputum Gene Xpert test. This case highlights the importance of maintaining a high index of suspicion when dealing with patients with polyarthritis.

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