The Great Imitator - Disseminated Tuberculosis Presenting as Baker’s Cyst: A Case Report
Tuberculosis is known to be a great mimicker, and it can present in a myriad of ways, which often result in an incorrect diagnosis. In a country that is endemic to tuberculosis, the presentation can take many forms ranging from tumour to trauma. We present a case of Baker’s cyst that was provisional...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Malaysian Orthopaedic Association
2022-03-01
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| Series: | Malaysian Orthopaedic Journal |
| Subjects: | |
| Online Access: | http://morthoj.org/2022/v16n1/disseminated-tuberculosis.pdf |
| _version_ | 1818261782231252992 |
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| author | Shakya A Patil N Kakadiya G Soni Y |
| author_facet | Shakya A Patil N Kakadiya G Soni Y |
| author_sort | Shakya A |
| collection | DOAJ |
| description | Tuberculosis is known to be a great mimicker, and it can present in a myriad of ways, which often result in an incorrect diagnosis. In a country that is endemic to tuberculosis, the presentation can take many forms ranging from tumour to trauma. We present a case of Baker’s cyst that was provisionally diagnosed as pigmented villonodular synovitis (PVNS) of the knee and eventually turned out to be tuberculous arthritis. A 46-year-old male presented with an insidious swelling on the posterior aspect of his knee for one year. Magnetic resonance imaging was suggestive of PVNS as the likely diagnosis. The patient presented 21 days later with a foot drop. On following-up with further investigations, he was found to have a lesion at the level of the L4-L5 spine. Chest radiograph changes were suggestive of tuberculosis. A synovial biopsy of the knee was done, and the tuberculosis culture report was positive. The patient was started on anti-tubercular treatment and then operated on, with arthroscopic synovectomy and posterior open cyst excision. The histology report was positive for tuberculous synovitis. The patient completed the course of anti- tubercular drugs and had physiotherapy. He demonstrated a clinically and radiologically healed disease at the final follow-up with a good functional outcome. Clinicians must have a high index of suspicion for tuberculosis, especially in endemic areas. Getting a chest radiograph is recommended in every case. Early diagnosis with the appropriate treatment will give a good functional outcome for the patient. |
| first_indexed | 2024-12-12T18:52:42Z |
| format | Article |
| id | doaj.art-bec3287a7b8e4dc181dc294f7c7b6964 |
| institution | Directory Open Access Journal |
| issn | 1985-2533 2232-111X |
| language | English |
| last_indexed | 2024-12-12T18:52:42Z |
| publishDate | 2022-03-01 |
| publisher | Malaysian Orthopaedic Association |
| record_format | Article |
| series | Malaysian Orthopaedic Journal |
| spelling | doaj.art-bec3287a7b8e4dc181dc294f7c7b69642022-12-22T00:15:21ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2022-03-0116112612910.5704/MOJ.2203.020The Great Imitator - Disseminated Tuberculosis Presenting as Baker’s Cyst: A Case ReportShakya A0Patil N1Kakadiya G2Soni Y3MS Orth MS Orth MS Orth MS Orth Tuberculosis is known to be a great mimicker, and it can present in a myriad of ways, which often result in an incorrect diagnosis. In a country that is endemic to tuberculosis, the presentation can take many forms ranging from tumour to trauma. We present a case of Baker’s cyst that was provisionally diagnosed as pigmented villonodular synovitis (PVNS) of the knee and eventually turned out to be tuberculous arthritis. A 46-year-old male presented with an insidious swelling on the posterior aspect of his knee for one year. Magnetic resonance imaging was suggestive of PVNS as the likely diagnosis. The patient presented 21 days later with a foot drop. On following-up with further investigations, he was found to have a lesion at the level of the L4-L5 spine. Chest radiograph changes were suggestive of tuberculosis. A synovial biopsy of the knee was done, and the tuberculosis culture report was positive. The patient was started on anti-tubercular treatment and then operated on, with arthroscopic synovectomy and posterior open cyst excision. The histology report was positive for tuberculous synovitis. The patient completed the course of anti- tubercular drugs and had physiotherapy. He demonstrated a clinically and radiologically healed disease at the final follow-up with a good functional outcome. Clinicians must have a high index of suspicion for tuberculosis, especially in endemic areas. Getting a chest radiograph is recommended in every case. Early diagnosis with the appropriate treatment will give a good functional outcome for the patient. http://morthoj.org/2022/v16n1/disseminated-tuberculosis.pdftuberculous arthritispigmented villonodular synovitiskneedelayed diagnosismultifocal |
| spellingShingle | Shakya A Patil N Kakadiya G Soni Y The Great Imitator - Disseminated Tuberculosis Presenting as Baker’s Cyst: A Case Report Malaysian Orthopaedic Journal tuberculous arthritis pigmented villonodular synovitis knee delayed diagnosis multifocal |
| title | The Great Imitator - Disseminated Tuberculosis Presenting as Baker’s Cyst: A Case Report |
| title_full | The Great Imitator - Disseminated Tuberculosis Presenting as Baker’s Cyst: A Case Report |
| title_fullStr | The Great Imitator - Disseminated Tuberculosis Presenting as Baker’s Cyst: A Case Report |
| title_full_unstemmed | The Great Imitator - Disseminated Tuberculosis Presenting as Baker’s Cyst: A Case Report |
| title_short | The Great Imitator - Disseminated Tuberculosis Presenting as Baker’s Cyst: A Case Report |
| title_sort | great imitator disseminated tuberculosis presenting as baker s cyst a case report |
| topic | tuberculous arthritis pigmented villonodular synovitis knee delayed diagnosis multifocal |
| url | http://morthoj.org/2022/v16n1/disseminated-tuberculosis.pdf |
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