Case report and review of literature: Subdeltoid bursa tuberculosis with
Corresponding Author(s) : Ashwin Kasturi
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 3 No. 2 (2015): 2015 Volume 3- Issue -2
Abstract
Introduction
We describe a rare case of a patient with unilateral musculoskeletal manifestation of tuberculosis presented as bursitis of the left shoulder with rice bodies , without coexisting active tuberculosis or tuberculosis in the previous history.
Case report
A 21 year old patient was examined, who complained of pain and swelling in the left shoulder for 2 years. MRI showed a large amount of rice bodies with joint effusion in the left shoulder with intact rotator cuff. The histological examination showed a tuberculosis-specific inflammatory response with giant cells and epithelioid granulomas. Arthroscopic debridement and removal of the loose bodies was done.
Conclussion
We report a unique case of tuberculosis sub deltoid bursitis with rice bodies formation in absence of any other concomitant focus of tuberculosis infection, managed with arthroscopic debridement and anti –tuberculosis (ATT) regimen for twelve months, with a long follow up of nine months.
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1. Hiroyuki Nagasawa, et al Tenosynovitis with rice body formation in a non-tuberculosis patient: A case report Ups J Med Sci. 2009 September; 114(3): 184–188.
2. Karthikeyan Iyengar ,et al Bilateral recurrent wrist flexor tenosynovitis and rice body formation in a patient with sero-negative rheumatoid arthritis: A case report and review of literature Int J Surg Case Rep. 2011; 2(7): 208–211.
3. Alkalay I, Kaufman T suprum H. Tuberculousis of the subdeltoid bursa Acase report Isr j Med Sci 1980;16:853-5
4. Jaovisidha S, Chen C, Ryu KN, Siriwong- pairat P, Pekanan P, Sartoris DJ, et. al Tuberculous tenosynovitis and bursitis: imaging findings in 21 cases. Radiology 1996; 201:507-13
5. Kim et al Tuberculous subdeltoid Bursitis with rice bodies. Yonsei Medical Journal 2002; 43; 539-42
6. Poper J. Rice – Bodies, Synovial Debris, and joint Lavage. BR. J Rheumatol 1985; 24:1-2
7. Poper AJ, Scott DL, Wainwright AC, Walton KW, Williamson N, Chapman JH. Frequency of occurrence, mode of devlop. And signi- ficance of rice bodies in rheumatoid jt. Ann Rheum Dis 1982;41:109-17
8. Cheung HS, Ryan LM. Kozin F, McCarty DJ, Synovial origins of rice bodies in joint, fluid Arthritis Rheum 1980; 23:72-6
9. WattsHG, Lifeso RM. Tuberculosis of bone and joints. J Bone Joint Surg Am 1996; 78:288-98
10. Dawson DJ, Blacklock ZM, Ashdown LR. Bittger EC.Mycobacterium Asiaticum as the probale causative agent in a case of olecranon Bursitis. J.lin Microbiol 1995; 33:1042-3
11. Holder SF, Hopson CN,Vonkuster LC. tuberculous arthritis of the elbow presenting as chronic bursitis of the olecranon . A case report. J Bone Joint Surg AM 1985; 67:1127-9
12. Schickendantz MS, Watson JT, Mycobacterial prepatellar bursitis. Clin Orthop 1990:258:209-12
13. Ihara K, Toyada K, Ofuji A, Kawai S, Tuber- culous bursitis of the greater trochanter. J Orthop Sci, 1998; 3:120-4
References
2. Karthikeyan Iyengar ,et al Bilateral recurrent wrist flexor tenosynovitis and rice body formation in a patient with sero-negative rheumatoid arthritis: A case report and review of literature Int J Surg Case Rep. 2011; 2(7): 208–211.
3. Alkalay I, Kaufman T suprum H. Tuberculousis of the subdeltoid bursa Acase report Isr j Med Sci 1980;16:853-5
4. Jaovisidha S, Chen C, Ryu KN, Siriwong- pairat P, Pekanan P, Sartoris DJ, et. al Tuberculous tenosynovitis and bursitis: imaging findings in 21 cases. Radiology 1996; 201:507-13
5. Kim et al Tuberculous subdeltoid Bursitis with rice bodies. Yonsei Medical Journal 2002; 43; 539-42
6. Poper J. Rice – Bodies, Synovial Debris, and joint Lavage. BR. J Rheumatol 1985; 24:1-2
7. Poper AJ, Scott DL, Wainwright AC, Walton KW, Williamson N, Chapman JH. Frequency of occurrence, mode of devlop. And signi- ficance of rice bodies in rheumatoid jt. Ann Rheum Dis 1982;41:109-17
8. Cheung HS, Ryan LM. Kozin F, McCarty DJ, Synovial origins of rice bodies in joint, fluid Arthritis Rheum 1980; 23:72-6
9. WattsHG, Lifeso RM. Tuberculosis of bone and joints. J Bone Joint Surg Am 1996; 78:288-98
10. Dawson DJ, Blacklock ZM, Ashdown LR. Bittger EC.Mycobacterium Asiaticum as the probale causative agent in a case of olecranon Bursitis. J.lin Microbiol 1995; 33:1042-3
11. Holder SF, Hopson CN,Vonkuster LC. tuberculous arthritis of the elbow presenting as chronic bursitis of the olecranon . A case report. J Bone Joint Surg AM 1985; 67:1127-9
12. Schickendantz MS, Watson JT, Mycobacterial prepatellar bursitis. Clin Orthop 1990:258:209-12
13. Ihara K, Toyada K, Ofuji A, Kawai S, Tuber- culous bursitis of the greater trochanter. J Orthop Sci, 1998; 3:120-4